Project SITUP: An Interdisciplinary Quality Improvement Initiative to Reduce Aspiration Pneumonia

Use of PDSA Cycles to Increase Aspiration Risk and Swallow Screening Documentation in the Hospitalized General Medical Patient Care Population

BACKGROUND

Aspiration, while hospitalized, can lead to increases in length of stay and health care costs. Nurses must identify patients at risk of aspiration early to initiate appropriate precautions.

LOCAL PROBLEM

An increase in-hospital patient aspirations at a Midwestern hospital prompted a review of events, which identified opportunities to improve identification of patients' risk factors and completion of the bedside swallow screening.

METHODS

Interventions were identified via a causal factor tree analysis and an impact-effort grid then deployed using the Plan-Do-Study-Act (PDSA) methodology.

INTERVENTIONS

Interventions deployed included game based-learning, a unit-based champion, and the use of visual cues to identify patients at risk for aspiration.

RESULTS

After 3 PDSA cycles, documentation of patients' aspiration risk factors on admission increased by 40%, with a 51.3% increase in bedside swallow screening results.

CONCLUSION

Iterative PDSA cycles successfully tested staff engagement strategies to improve aspiration risk and swallow screening documentation compliance.

[Swallowing disorders, training and assessment of geriatric practices]

In geriatrics, swallowing disorders are frequent, representing a daily source of anxiety for the nursing teams. Training in this area, aimed at caregivers in a long-stay care unit, has been developed based on an assessment of professional practices.