SAN ANTONIO, Tex.—Implementation of the Massey Bedside Swallowing Screen and strict oral care regimens in high-risk patients reduced the rate of hospital-acquired pneumonia (HAP) at an oncology treatment center, study results presented at the ONS 41st Annual Congress have shown.1
HAP is a leading cause of prolonged hospitalization. “Oncology population is especially susceptible to critical illness due to an already immunecompromised state,” explained Cheryl Clements, BSN, RN, PCCN. The Massey Bedside Swallowing Screen can be used as a preliminary screening of a patient’s swallowing abilities.
In this study, the Massey Bedside Swallowing Screen was administered on admission to the oncology telemetry unity at the Cancer Treatment Centers of America facility in Philadelphia, Pennsylvania, to detect swallowing deficits that could increase a patient’s susceptibility to developing HAP.
Patients who were identified as high risk for HAP were educated about their risk and provided with a simple oral care regimen, if they could perform their own mouth care. Acutely ill patients who were unable to perform their oral care were placed on strict oral care from the nursing staff. Compliance with the protocol was audited by the charge nurse.
Before the intervention, HAP rates were measured from January to April 2015. In a total of 1065 patient days, 4 cases of HAP were diagnosed in the unit for an incidence rate of 2.45 per 1000 patient days, reported Clements.
After implementation, a 50% reduction in HAP cases was seen with 2 new cases of HAP reported between May and August 2015 for an incidence of 1.35 per 1000 patient days. “Data collected from September 2015 to March 2016 reveal no additional cases of HAP on the unit,” Clements said. Nurse compliance with the protocol was 65.5%.
These results emphasize the importance of screening for swallowing deficits that may indicate a high risk for aspiration. Early detection can allow for implementing oral care interventions that can result in improved patient outcomes and decreased incidence of HAP.
1. Slavin K, Dunbar R, Bonawitz M Clements C, McGovern J. Taking HAP off the map with a routine screen. Oral presentation at: Oncology Nursing Society 41st Annual Congress; April 29-May 1, 2016; San Antonio, TX.