P1515 - Aspiration Precaution Order Set Implementation: Quality Improvement Project to Decrease Aspiration Events

Nada Saleh, MD, Luqman Baloch, MD, Thayer Hamoudah, MD, Altaf Dawood, MD, MBBS, Naser Khan, MD
Mercy Health, Rockford, IL

Introduction: Aspiration is a common complication that can happen in all individuals, regardless of age or health. Aspiration events increase in-hospital mortality, prolong length of stay, and lead to poor health outcomes in hospitalized patients. We present a quality improvement project utilizing an aspiration precaution order set to help lower the incidence of aspiration events. Hospital staff were educated about the risk factors associated with aspiration and advised utilization of the order set.

Methods: A multicenter, retrospective cohort study was conducted that compared the incidence of aspiration events after implementation of a system-wide aspiration precaution order set. Data included all hospitalized patients from 01/01/2019 to 04/30/2024. The primary endpoint was to assess the incidence of aspiration events within the first 6 hours of admission or order set implementation. Secondary analysis included hospital length of stay, intensive care unit length of stay, and use of mechanical ventilation.

Results: A total of 3,963 patients were found in our analysis. 925 patients were in the order set group. 3,037 noted to be in the non-order set group. A total of 414 patients were excluded as they were diagnosed with aspiration within the 6 hours of admission or order set use. A random sample of 770 patients were selected from the 2,276 non-order set group. A total of 772 patients in the order set group was compared to the random 770 patients in the non-order set group. 20 out of 772 (2.6%) patients were found to have aspiration events after 6 hours from initiating the aspiration precautions order set. 130 out of 770 (16.9%) were found to have aspiration events after 6 hours from admission in the non-order set group. Chi-square test for independence was 88.06 with a P-value < 0.001. Meanwhile the odds ratio was noted to be 0.131 (95% CI: [0.071, 0.244]) with P-value < 0.001.

Discussion: Patients with the order set experienced fewer incidences of aspiration in comparison to those without the order set. Chi-square analysis shows a statistically significant increase in aspiration events in the non-order set group. Odds ratio is less than 1, which indicates decrease of odds of aspiration events in the order set group. Data suggests length of stay in the hospital and intensive care unit were prolonged in the patients without the precautions order set. Our study proves that implementing aspiration precautions in hospitalized patients significantly decreased the odds and incidence of aspiration events.


Disclosures:


Nada Saleh, MD, Luqman Baloch, MD, Thayer Hamoudah, MD, Altaf Dawood, MD, MBBS, Naser Khan, MD. P1515 - Aspiration Precaution Order Set Implementation: Quality Improvement Project to Decrease Aspiration Events, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.