Pre- and Post- Aspiration Prevention Survey Post-Intervention Additional Qualtrics Survey Questions Aspiration Precautions Compliance Audit Tool Room # Aspiration Precautions Order (Y/N) SAFER Sign at Head of Bed (Y/N) Ambubag in Room (Y/N) Suction Setup (Y/N) Additional Notes 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Project Timeline Week # Date Deliverables/Activities 1 June 17 June 18 June 21 Initial Email to 14M RNs (brief introduction of the project, invitation to participate in the Qualtrics survey, and inform about 1:1 in-service sessions) Notification of the Head of Hospital Medicine Team about the EBP Project, Head announced the project to the Doctors Notification of the SLP supervisor of the Project to inform the team Preparation of supplies, ensuring unit had adequate SAFER signs, 2 suction regulators for each patient (one for suction setup and one for external urinary device). Asked carpentry to fix broken canister holders. R equested for modification to CUHSR application 2 June 24 June 26-27, & 30 Received approval for modification from CUHSR 2 Decision tree posters placed in the charting rooms. Tool prepared in the designated folder. SAFER signs placed in the designated folders. 1:1 In-service sessions. Met with HUSCs to inform on how to distribute and collect the tool Reviewed the SAFER sign with the PCAs 3 July 1 Go-Live for the tool On-site support and guidance for nurses/address any questions and concerns 4 July 8 July 9 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Presented the project to the Hospital Medicine Team and UBLT 5 July 15 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Provide d support, answer questions, and collect feedback 6 July 22 July 24 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Staff Meeting* Provide d support, answer questions, and collect feedback 7 July 29 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Provide d support, answer questions, and collect feedback 8 August 5 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, A mbubag]) Provide d support, answer questions, and collect feedback 9 August 12 August 17 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Provided support, answer questions, and collect feedback Shared mid-implementation data to unit leadership and stakeholders 10 August 19 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Provide d support, answer questions, and collect feedback 11 August 26 Weekly Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag]) Provide d support, answer questions, and collect feedback 12 Sept 2 Sept 8 Final week for project implementation Final Audit (use of the tool and direct observation of equipment [SAFER sign, suction set up, Ambubag])/data collection Sent another email to 14M RNs for the post-implementation Qualtrics survey End of 12 - wk implementation Phase Data compilation/collection/analysis Supplemental Data on Aspiration Risk Identification and Preventive Measures At-Risk Patients Identified Aspiration Precautions Order SAFER Sign Bedside Swallow Screening Bedside Swallow Screening Result Care Plan Pass Fail JULY 53 48.18% 47 88.68% 51 96.23% 48 90.57% 31 58.49% 19 35.85% 34 64.15% AUGUST 48 37.50% 42 87.50% 44 91.67% 39 81.25% 28 58.33% 11 22.92% 38 79.17% SEPTEMBER (1-8) 15 34.09% 10 66.67% 14 93.33% 12 80.00% 3 20.00% 9 60.00% 8 53.33% Total 115 40.78% 99 86.09% 109 94.78% 99 86.09% 62 53.91% 39 33.91% 80 69.57% NPOA-AP Rate Pre-and Post-Implementation NPOA-AP Cases, Monthly Census, NPOA-AP Rate Per Month Month NPOA-AP Cases Monthly Census NPOA - AP Rate (per 1,000 Patients) August (Pre) 2 836 2.39 September (Pre) 3 817 3.67 October (Pre) 3 845 3.55 November (Pre) 2 812 2.46 December (Pre) 4 825 4.85 January (Pre) 2 851 2.35 February (Pre) 1 798 1.25 March (Pre) 2 851 2.35 April (Pre) 1 823 1.22 May (Pre) 2 848 2.36 June (Pre) 3 818 3.67 Pre - Implementation Total 25 9,124 2.74 July (Post) 0 845 0 August (Post) 3 846 3.55 September 1-17 (Post) 0 461 0 Post - Implementation Total 3 2,152 1.39 Aspiration Risk Assessment Tool Utilization by Month Month Total Number of Admissions Tool Use Tool Utilization Rate (%) July 110 87 79.09 August 128 95 74.22 September (1 - 8) 44 28 63.64 Total 282 210 74.47 Direct Observation of Equipment by Audit Date Audit Date (2024) "Aspiration Precautions" Patients SAFER Sign Suction Setup Ambu bag July 7 16 11 15 16 July 14 14 14 14 14 July 21 16 14 16 16 July 28 8 8 8 8 August 4 15 14 14 14 August 11 16 16 16 16 August 21 17 16 16 16 August 25 16 15 14 15 September 1 11 10 10 10 September 7 13 12 11 12 Total 142 130 133 137 % Compliance 91.5% 93.7% 96.5% Aspiration Prevention Survey Results (Pre- and Post-Implementation) Pre - Implementation (N=33) Post - Implementation (N=18) Q1 94% 100% Q2 88% 89% Q3 100% 100% Q4 100% 100% Q5 79% 61% Q6 42% 56% Q7 73% 83% Q8 91% 94% Q9 76% 78% Q10 94% 94% Average Score 83.70% 85.50% Satisfaction and Effectiveness Ratings for the Aspiration Risk Screening Tool and Protocol