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...

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'…