Educating on Aspiration Pneumonia Prevention

Aspiration Pneumonia Prevention through in-Service Training for Nurses NR451 RN Capstone Course Design for Change Proposal: Aspiration Pneumonia Prevention through in-Service Training for Nurses This is a position paper recommending the implementation of an in-service training among nurses in the hospital and skills nursing facilities on the prevention of aspiration pneumonia, of which a large segment of the sufferers are elderly patients.

Especially in the case of elderly patients with nasogastric or under peg tube feeding, the need for nurses taking care of these patients is essential to ensure correct and proper care and safety for the patient. In this paper, the proponent of this paper will discuss relevant literature on the effectiveness of in-service nurse training in preventing aspiration pneumonia. Further, after this review of relevant literature, the proponent will present an action plan that the hospital management can review and take into consideration.

Change Model Overview In developing this proposal, the proponent will implement the Johns Hopkins EBP model, which shall outline my proposal based on the following components: Practice Question, Evidence, and Translation (Newhouse et. al., 2007, 41). Adaptation of this model in developing this proposal will keep the proponent aligned with the desired outcome of this proposed in-service training: to reduce patient safety risk and death resulting from aspiration pneumonia.

In implementing the EBP or evidence-based practice model, the proponent will develop the practice question based on the PICO approach to developing the practice question or stating the practice problem: identify the patient, population and/or problem. After this, evidence will be given based on research studies that the proponent has collected from her literature review. Lastly, the findings from the literature review will then be translated into an action plan, providing specific steps and/or guidelines on how the proposed change will be implemented in the hospital.

Practice Question Does requiring mandatory in-service or training for all staff on aspiration pneumonia prevention decrease the number of incidence among the geriatric population with peg tube feeding at a skill nursing facility SNF as compared to not requiring a mandatory in-service? The above practice question identifies the geriatric population with peg tube feeding as the target patient population of the intervention. The proposed intervention, meanwhile, is a mandatory in-service training for all staff dealing with the same patient population.

Staff who received in-service training on aspiration pneumonia prevention will be compared to the performance and status of patients of staff not trained on the proposed training program. The intended outcome of the in-service training is to decrease the number of incidence of aspiration pneumonia among the elderly who are dependent on the nursing staff for their daily health needs and requirements.

A latest study on aspiration pneumonia found that its prevalence can be as much as 50%, data taken from a survey of two (2) urban nursing homes in South Korea (Liantonio et. al., 2014). This prevalence rate is an indication of the possibility that indeed, the case could be the same in nursing facilities in the United States.

The proponent's proposal, in fact, was motivated by the fact that, based on observation, there is indeed a need to change the current practice and ensure the nursing facility patients' health and safety through a staff trained and knowledgeable on preventing aspiration pneumonia. Evidence Literature relevant to the topic under study is abundant, mainly because of its prevalence as well in hospitals and nursing facilities. Aspiration pneumonia had been attributed to different causes, more often in the course of providing healthcare to the elderly patient.

The most common cause was dysphagia or difficulty in swallowing, which almost always, required the use of a nasogastric or feeding tube to provide the patient with sustenance and nutrition. In reviewing the literature for the proposed intervention plan for preventing aspiration pneumonia caused from the use of nasogastric tube, the proponent found out that in one study, a similar intervention had already been implemented. Residents and staff of a hospital were trained on an intervention protocol that improved the patients' oral hygiene and swallowing.

In this protocol, staff and residents were given step-by-step procedures for oral hygiene and feeding of the patients. Results of the study showed that the intervention protocol was considered "highly feasible" if it was only done for less than 10 minutes every day. Beyond this period, the intervention protocol would be less likely to be adhered to or followed and successfully implemented by residents and staff.

Further, among the intervention protocols implemented, it was the feeding positioning and instruction to patients on swallowing techniques were found to be more effective and the most that staff adhered to than manual brushing (Quagliarello et. al., 2009, 4, 6). Translation The proponent will take a more pragmatic approach in developing a change or intervention plan in helping the nurses cope with the demand to increase patient safety through aspiration pneumonia prevention.

While a review of the literature suggested numerous ways or protocols that can be followed to prevent aspiration pneumonia, the recommended action plan for the nursing facility under study is to inform nurses about the possible options or care that they could adopt and implement while caring for their patients. For the proposed change plan in the concerned nursing facility, the proponent proposes to implement an oral care hygiene protocol, which is particularly important for patients fed using feeding tubes.

Its effectiveness had been documented significantly in studies of a similar kind of medical problem (aspiration pneumonia) (Ebihara and Ebihara, 2011, 341). As part of improving the protocol, nurses and.