Article #1: Becker, R., et al. (2011). “Functional dysphagia therapy and PEG treatment in a clinical geriatric setting.” Dysphagia, 26, 108-116.
1). Summary: The article by Becker et al. delves on the outcomes of two Functional Dysphagia Therapy (FDT) with one group using percutaneous endoscopic gastrostomy (PEG), and another group of non-PEG users.
2) Element: The victims of stroke and those with cerebrovascular diseases have neurogenic dysphagia, 50% and 30% respectively. The result of this study revealed a mortality rate of 19.7%, and lower for the second group of non-PEG users which is at 8.6%.
3) Outcome: Those in group one showed improvement in drinking and eating, while the second group showed major improvement in intake in nutritional ingestion.
4) Significance: the authors stress the importance of PEG in the treatment and maintenance of dysphagia.
Article #2: Benati, G., Coppola, D., & Delvecchio, S. (2009). “Staff training effect on the management of patients with dysphagia in a nursing home.” National Therapy and Metabolism, 27(2), 95-99.
1) Summary: The article builds on the premise that dementia ranks number four as a cause of death in Western countries, of which dysphagia is found to be common during the onset and the late stages of dementia.
2) Element: The research described in this article examined the results of staff training in a nursing home on aspects dysphagia and dementia.
3) Outcome: The succeeding results revealed that after a 6-month period, the second group of subjects exhibited a significantly smaller number of tube-fed patients, x-ray swallowing exams and hospital admissions due to aspiration pneumonia.
4) Significance: The authors emphasize the importance of staff training in order to maximize proper management of those suffering from dysphagia and dementia in nursing homes.
Article #3: Cichero, J., Heaton, S., & Bassett, L. (2009). “Triaging dysphagia: nurse screening for dysphagia in an acute hospital.” Journal of Clinical Nursing, 18, 1649-1659.
1) Summary: This article discusses the immense economic cost of failure to properly diagnose dysphagia. Using quasi-experimental method, nurses were evaluated for pre and post training dysphagia, stages of swallowing, and its relation to aspiration.
2) Element: The assessment of nurses prior and after training sessions coincides with nurse-screening of patients for dysphagia. This included diagnostic categories, patient/career interview, dysphagia indicators, and water swallow tests.
3) Outcome: Results on the 442 patients screened revealed a sensitivity of 95%, specifity of 97%, positive predictive and negative predictive values of 92% and 98% respectively, and a compliance rate of 85%.
4) Significance: the authors suggest that since about 25% to 30% of acute patients have dyspagia, proper identification of patients with or without dysphagia will greatly improve allocation of heath care and will likewise result to less cost for patients.
Article #4: Cabre, M., Serra-Prat, M., Force, L., Almirall, J., Palomera, E., & Clave, P. (2014). “Oropharyngeal dysphagia is a risk factor for readmission for pneumonia in the very elderly persons: observational prospective study.” Journals of Gerontology Series A: Biological Sciences & Medical Sciences, 69(3), 330-337.
1) Summary: The article discussed how oropharyngeal dysphagia is a major basis for readmission for elderlies previously discharged from an acute geriatric unit. The focus of this research centered on those 75 years old and above with pneumonia.
2) Element: The information sued for this study come from clinical databases pertaining to individuals discharged from acute geriatric departments from June of 2002 to December of 2009, up to either their times of death or until December 31, 2010.
3) Outcome: The research results revealed that the ratio of the 186 patients-participants is subdivided into 7.9% on pneumonia, 24.2% on aspiration pneumonia, and 52.7% on pharyngeal dysphagia.
4) Significance: The authors of this article accentuate that oropharyngeal dysphagia should be studied more extensively and applied in the nursing profession in order to lessen the incidences of readmission due to Oropharyngeal dysphagia disorders.
Article #5: Coker, E., Ploeg, J., Kaasalainen, S., & Fisher, A. (2013). “A concept analysis of oral hygiene care in dependent older adults.” Journal of Advanced Nursing, 2360-2371.
1) Summary: This article is based on the tenet that good oral care is important in averting aspiration pneumonia and periodontitis.
2) Element: Concept analysis method of Walker and Avant is utilized to investigate the importance of oral care in elderly patients.
3) Outcome: The results of this study include improved oral care by patients, particularly the oral cavity, removal of plaques, and sustaining appropriate levels of moisture in oral tissues.
4) Significance: The authors of this article stress that oral care must be incorporated in the nursing module given that it can prevent certain diseases, such as aspiration pneumonia, in the elderly patients.
Article #6: Durgude, Y., & Cocks, N. (2011). “Nurses’ knowledge of the provision of oral care for patients with dysphagia.” British Journal of Community Nursing, 16(12), 604-610.
1) Summary`: This article discusses data collected from nurses by means of a questionnaire, on the importance of oral care in patients with dysphagia.
2) Element: The method used is a 20-item questionnaire developed by Adams, with modifications incorporated in them in order to focus on adaptations and consequences of oral care to those with dysphagia.
3) Outcome: The results revealed a high qualification rate for the 53 nurse participants, whereby 75.5% had been qualified for over six years and 85% had work experiences in nursing homes for at least two years.
4) Significance: This article forwards a tenet on the importance that that nurses play in providing oral care to patients with dysphagia, and in a less stringent manner to patients who are not diagnosed with such a disease.
Article #7: Duffin, C. (2010). “Raising awareness of dysphagia among healthcare professionals.” Learning Disability Practice, 13(4), 21-24.
1) Summary: Patients with learning disabilities are at risk if they are not provided with suitable food for their condition. This is because of the complexity and risks involved in swallowing the wrong kinds of food and liquid.
2) Element: The methods used include training staff in using PEG tubes and promoting good practice in swallowing food and liquids.
3) Outcome: The increase in awareness resulted in administrative changes which cover assessment, care planning, menu design, and food preparation and presentation, among others.
4) Significance: The authors of this article emphasize that assisting patients with learning disabilities help minimize injuries and deaths due to improper swallowing.
Article #8: Echevarria, I.M., & Schwoebel, A. (2012). “Development of an intervention model for the prevention of aspiration pneumonia in high-risk patients on a Medical-Surgical unit.” MEDSURG Nursing, 21(5), 303-308.
1) Summary: This article discusses the importance of establishing an appropriate procedure necessary in the maintenance and prevention of aspiration pneumonia. Some of the statistics presented by the study is the incidence of dysphagia between 42% and 67% of patients during the the first three days of a stroke, and incidents of aspiration for stroke victims between 19.5% to 42% during the initial five days.
2) Element: A decisive assessment of the model was executed during the trial phase, wherein the nurses were asked for their respective feedbacks on the model’s usability and accuracy of the Risk Assessment Tool. Likewise, adherence to the model was done in a weekly basis.
3) Outcome: The result of this study reveals a 20% to 65% Mortality rates for aspiration pneumonia, which is parallel with the assessments in the first two months of the protocol whereby 49% were placed under precautionary status.
4) Significance: The authors emphasize that adherence to the intervention model mentioned in the research will lessen the elevated presence of aspiration pneumonia along with the high cost associated with the disease.
Article #9: Eisenstadt, E.S. (2010). “Dysphagia and aspiration pneumonia in older adults.” Journal of the American Academy of Nurse Practitioners, 22, 17-22.
1) Summary: This article discusses the dangers, diagnosis, and prevention of aspiration pneumonia for the elderly 65 years old and above.
2) Element: The article used data from PubMed and CINAHL, focusing on findings that diagnosis of aspiration pneumonia in the elderly is linked with high rates of morbidity and mortality.
3) Outcome: Results of the study mentioned in the article identify ageing and multiple risk causes, especially dysphagia due to stroke and dementia, comprise the major causes of AP in the elderly.
4) Significance: The article emphasize that increasing nurses’ knowledge on pneumonia is important since it will improve health care allocation to those with such an ailment, most notable of which are the elderly.
Article #10: Jomori, I., & Hoshiyama, M. (2010). “Effects of music therapy on involuntary swallowing.” Nordic Journal of Music Therapy, 19(1), 51-62.
1) Summary: Music therapy (MP) can increase voluntary swallowing for the elderly suffering from brain dysfunctions, inclusive of which are the prevention of aspiration and recovering swallowing functions.
2) Element: Before the MP sessions, the average number of swallows among the10 elderly patients were 16.5 per hour. This average increased to about 25.9 during the MP sessions, with a average discrepancy of plus and minus 15.8.
3) Outcome: This article explains that MP can improve the swallowing of the elderly, especially during the singing phase. This technique is especially recommended to patients who experiences difficulties in oropharyngeal movements.
4). Significance: The authors stress on the need for therapists and other medical professionals to consider MT in improving voluntary skills of elderly patients.
Article #11: Pace, C.C., & McCullough, G.H. (2010). “The association between oral microorganisms and aspiration pneumonia in the institutionalized elderly: review and recommendations”. Dysphagia, 25, 307-322.
1) Summary: This article argues that oral care among the elderly must be promoted because oropharyngeal secretions can percolate the lungs and thus cause infections.
2) Element: Data gathered from PubMed and MeSH reveal that Community-Acquired Pneumonia (CAP) infects 11.6 persons out of 1,000 adults per year. Also, Hospital-Acquired Pneumonia (HAP) accounts for 15% of all contagions in hospital environment, with Aspiration Pneumonia (AP) numbering to about 200,000 infections per year in the United States.
3) Outcome: The resulting mortality rates for the CAP are as such: for HAP the figure averages between 21% to 70% among ICU patients, and in the case of aspiration pneumonia it is about 15,000 deaths per year.
4) Significance: The authors of this article give emphasis to the notion that Nurses must be prepared to provide adequate oral care to patients to prevent microorganisms from contributing to the development of aspiration pneumonia.
Article #12: Robbins, J. et al. (2008). “Comparison of 2 interventions for liquid aspiration on pneumonia incidence.” Annals of Internal Medicine, 148(7), 509-519.
1) Summary: The authors of this article believe that there is very limited knowledge in aspiration pneumonia in the elderly despite of its high incidence.
2) Element: The design for this research involved a random, parallel-design spanning 3-month periods. It involves the comparison on the success ratios between chin-down posture and and thickened liquid.
3) Results: The results among the 52 participants showed an 11% cumulative incidence, whereby those patients designated to the thickened liquids as opposed to those assigned to chin-down posture had dehydration, UTI, and fever.
4) Significance: The authors of the article strongly emphasize that the chin-down posture must be extensively researched in order to maximize its full potential, since it proved to be more capable of improving pneumonia incidents.
Article #13: Sandhaus, S. (2009). “Promoting evidence-based dysphagia assessment and management by nurses.” Journal of Gerontological Nursing, 35(6), 20-27.
1) Summary: This article discusses the evidence-based model of the OMRU.
2) Element: The method used is a single group pre-test post-test design in aim to assess nurses’ knowledge.
3) Results: The result of eh study mentioned in the article explains that out of the 122 nurses attendees, nurses’ experiences are shown to be 1 month to 44 years long, with most having work experiences in medical-surgical units, SNF, and geropsychiatric units and ICU.
4) Significance: The authors stress that utilizing nurses with prior experiences in sensitive areas is a must in ensuring appropriate care on elderly with dysphagia.
Article #14: Yamasaki, M, et al. (2010). Effects of capsiate on the triggering of the swallowing reflex in elderly patients with aspiration pneumonia. Geriatrics Gerontology International, 10, 107-109.
1) Summary: Dysphagia is refers to the delay of mechanism in swallowing both liquid and solid, which prejudices an individual to develop aspiration pneumonia.
2) Element: The article confirms that the introduction of capsiate promotes return of the swallow reflex sensitivity for those suffering from dysphagia.
3) Outcome: The article stresses that because of the continued rise in mortality rates on aspiration pneumonia, it has continued to be a foremost concern for the elderly.
4) Significance: The article emphasize that nurses must be competent in administering capsiate to elderly patients in order to provide competent health care services to the elderly.
Article #15: Young, S.K. (2012). Influence of manual facilitation technique on swallowing disorder and aspiration pneumonia caused by severe dysphagia with stroke. Journal of Physical Therapy Science, 24, 909-913.
1) Summary: It has been proven that the Manual Facilitation Technique (MFT) is successful in the prevention of aspiration dysphagia following a stroke.
2) Element: The method used included three subjects who reacted positively to the introduction of a swallowing technique, covering 13 attempts in 20 minutes.
3) Outcome: The 13 saliva swallows resulted to the subject #1(M, 65 y/o) having an average of 3.79 times; for subject #2 (M, 63 y/o) it was had 4.93; and for subject #3 (F, 59 y/o) it was had 5.71 times in average.
4) Significance: The authors argue that nurses must be taught to properly administer the said saliva swallowing technique in order to maximize allocation of health care services.
Good Article Review On Review Of The Literature On Aspiration Pneumonia
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Article #1: Becker, R., et al. (2011). “Functional dysphagia therapy and PEG treatment in a clinical geriatric setting.” Dysphagia, 26, 108-116.
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