Reducing hospital aquired pneumonia (HAP) with Massey Screen.

232 Background: Hospital Acquired Pneumonia (HAP) is a leading cause of prolonged hospitalization in patients. The oncology population is especially susceptible to critical illness related to an immunocompromised state. The purpose of this study was to implement the Massey Bedside Swallowing Screen upon admission to the oncology telemetry unit to detect any deficits that could potentially lead to HAP, in conjunction with strict oral care for identified high risk patients.

METHODS: The importance of the Massey Bedside Swallowing Screen upon admission and the knowledge that early detection leads to better patient outcomes was educated to the nursing staff. Every patient admitted to the oncology telemetry unit was screened with the Massey Bedside Swallowing Screen. Patients identified as high-risk were placed on nothing-by-mouth (NPO) precaution. A Speech and Swallow Evaluation was ordered to further evaluate the patient. Acutely ill oncology patients unable to perform their own oral care were placed on a strict oral care regimen performed by the nursing staff. The charge nurse audited compliance with this protocol.

RESULTS: The pre-intervention phase of the study evaluated January - April 2015 included 1,605 patient days. The data revealed 4 HAPs acquired on the oncology telemetry unit, demonstrating 2.45 incidence/1000 patient days. Post-intervention [May - August 2015] indicated 2 HAPs acquired on the oncology telemetry unit, signifying 1.35 incidence/1000 patient days. With the implementation of the Massey Bedside Swallowing Screen for each patient upon admission, and strict oral care regimen for high-risk patients, the overall incidence of HAP on the unit decreased by 50%.

CONCLUSIONS: Oncology patients assessed with the Massey Bedside Swallowing Screen upon admission to the oncology telemetry unit were noted to have improved outcomes and lower rates of HAP. Every oncology patient admitted to an acute care unit should have an admission screen in place to evaluate risk for aspiration. Early detection of patients at high-risk for HAP and implementation of interventions to improve oral care in high-risk patients lead to improved patient outcomes through lower incidence of HAP in the acute care setting.