Recommendations of good practice to prevent aspiration pneumonia in older adults at risk of oropharyngeal dysphagia living in nursing homes: A modified e‐Delphi study protocol

Background Aspiration pneumonia (AP) is a subset of pneumonia caused by the aspiration of food and fluids to the lungs and is highly prevalent in the older population. Oropharyngeal dysphagia (OD) is one of the risk factors for AP and it is also associated with malnutrition, dehydration and poor fun...

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Bibliographic Details
Published in:International journal of language & communication disorders 2024-05, Vol.59 (3), p.1223-1231
Main Authors: Santos, Joana M. L. G., Ribeiro, Oscar, Jesus, Luis M. T., Sa‐Couto, Pedro, Matos, Maria Assunção C.
Format: Article
Language:English
Subjects:
Adults
Aged
Aged, 80 and over
Aspiration
aspiration pneumonia
At risk populations
Consensus
Deglutition Disorders
Delphi method
Delphi Technique
Dysphagia
good practices
Homes for the Aged
Humans
Language therapy
Nursing Homes
older adults
Older people
Pneumonia
Pneumonia, Aspiration - etiology
Pneumonia, Aspiration - prevention & control
Practice Guidelines as Topic
Prevention
quality of care
Quality of life
Risk Factors
Speech therapy
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Summary:Background Aspiration pneumonia (AP) is a subset of pneumonia caused by the aspiration of food and fluids to the lungs and is highly prevalent in the older population. Oropharyngeal dysphagia (OD) is one of the risk factors for AP and it is also associated with malnutrition, dehydration and poor functional outcomes. As pneumonia is the second most common infection in nursing homes (NHs) and OD represents a major concern to NH staff, good practices for the prevention of AP in older adults at risk of OD are needed. Purpose The aim of this modified e‐Delphi study is to build consensus among a panel of experts regarding a set of recommendations for NH staff on good practices to prevent AP in older adults at risk of OD living in NHs. The objective of this paper is to establish the methodology inherent to the Delphi study. Methods An online modified Delphi study will be developed in three rounds. Criteria for the Delphi panel participants include holding a master's or doctoral degree in OD or speech and language therapy; or having 10 or more years of experience in OD; or having at least one scientific publication related to OD. A previously described modified Delphi methodology will be used to achieve consensus (75% agreement). An additional round will be performed to collect the experts’ perspectives regarding the priority for application of each recommendation previously validated. Discussion This protocol aimed to describe the methodology of a future Delphi study on the prevention of AP, seeking to fulfil the gap in the literature regarding this topic. The modified Delphi technique is a widely used method for collecting experts’ opinion in health sciences, but the absence of standardised guidelines allows some heterogeneity between studies with the same aim. WHAT THIS PAPER ADDS What is already known on the subject Aspiration pneumonia (AP) is related to three main risk factors: impaired safety of swallow, impaired nutritional status and poor oral health. It is known that being dependent for feeding is one of the main risk factors for AP and around 50% of nursing home (NH) residents need feeding assistance. Thus, it is important to promote specialised intervention and care by the NH staff for preventing AP. What this paper adds to existing knowledge It is hypothesised that increasing the knowledge of NH staff regarding the best practices for preventing AP in older adults at risk of oropharyngeal dysphagia (OD) will improve outcomes such as quality of life, in
ISSN:1368-2822
1460-6984
DOI:10.1111/1460-6984.12985