Evaluating a Bundled Protocol to Reduce Aspiration Pneumonia in Critically Ill Tube-Fed Patients
Keywords:
Aspiration pneumonia, Critical care , Bundle protocol , Enteral feeding , Nasogastric tube , Quality improvementAbstract
Background: Patients who are severely ill and are fed through a nasal tube mostly suffer from aspiration pneumonia. Objective: To evaluate the degree to which an exploratory, evidence-based, and multifaceted method lowered the aspiration pneumonia in critically ill tube-fed patients. Methods: A historical observation group study was carried out by the Critical Care Unit at a tertiary care hospital. For the period of January to December 2021, a control group consisting of 415 individuals got usual care. This group was compared to an experimental group consisting of 2,120 individuals who received additional help for the period of January 2022 to December 2024. As part of the combining method, 30–50 mL of water were flushed after each enteral dose, drugs were given as normal (crushing, decreasing, and flushing between doses), and overnight fasting was strictly limited to six hours. The main effect was incidents of aspiration pneumonia. Results: The intended surgery reduced aspiration pneumonia from 14.7% to 7.8%. After controlling for other factors, the method reduced aspiration pneumonia by 52% (OR=0.48, 95% CI=0.35–0.66). Bundling adherence (≥90%) was linked to decreased incidence (5.2% vs. 13.3% for poor adherence). Reduced median ICU stay (7.0 days vs. 9.0 days) and 22% fewer antibiotic days were noteworthy advantages. Conclusions: Placing forward a cohesive aspiration prevention plan approach led to fewer incidents of aspiration pneumonia and favorable secondary clinical outcomes in critically ill patients who received nutrition by tube. In critical care, this practical procedure assists in making enteral nutrition safer and superior.
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