Abstract
ABSTRACT Objective: to manage the risk of bronchoaspiration in patients with oropharyngeal dysphagia through signalizing plates in the hospital bed. Methods: a descriptive, quantitative study, developed in the medical clinic I (diagnostic investigation), medical clinic II (infectology / pneumology), surgical clinics and intensive care unit of the University Hospital of the Federal University of Sergipe, from February to August 2017. It was composed of patients in the age group ≥ 18 years of age, of both sexes, diagnosed with oropharyngeal dysphagia, based on the application of the adapted protocol of clinical evaluation in the hospital bed and instrumental examination of swallowing, when pertinent. Following the clinical evaluation and identification of the risk of bronchoaspiration due to oropharyngeal dysphagia, the signs were inserted at the hospital bed by the speech therapist. Results: the study included 43 patients at risk of bronchoaspiration due to oropharyngeal dysphagia, average age of 53.7 ± 3.53 years old, with 51.1% (n = 22) females and 48.9% (n = 21) males. A predominance of neuropathies (53.4%) and severe neurogenic oropharyngeal dysphagia (37.2%) was observed. The intensive care unit stood out with 44.18% (n = 19) of the application of signs of risk of bronchoaspiration. Conclusion: the management of bronchoaspiration risk has been shown to be a promising measure to reduce adverse events, which affect the patient's safety and consequently the quality of care in the hospital environment, as well as a possible strategy for measuring respiratory complications triggered by aspiration of oropharyngeal contents.
Highlights
Bronchoaspiration is considered one of the main indicators of dysphagia and the most worrying[1,2]
This study was approved by the Ethics and Research Committee of the Federal University of Sergipe under the pronouncement No 1,275,790 in October 2015 and submitted to the evaluation of the Serviço de Controle de Infecção Relacionada à Assistência à Saúde (Service of Control of Infection Related to Health Care) – SCIRAS - for applicability in the institution. This is a descriptive, cross-sectional, quantitative study that aimed at managing the risk of bronchoaspiration in patients with oropharyngeal dysphagia through signaling plates in hospital bed
Belonging to a larger project entitled “Caracterização da disfagia orofaríngea dos pacientes internados no Hospital”, developed at the University Hospital of Sergipe by a resident of the Programa Saúde do Adulto e do Idoso da Residência Multiprofissional em Saúde (Adult and Elderly Health Program of the Multiprofessional Health Residency), from February to August 2017. It covered all patients of both sexes, aged ≥ 18 years old, hospitalized in the medical clinic I, medical clinic II, surgical clinic and intensive care unit (ICU)
Summary
Bronchoaspiration is considered one of the main indicators of dysphagia and the most worrying[1,2]. It occurs through the infiltration of food particles, oropharyngeal fluids or gastric contents into the lower airways, which can trigger infectious pneumonia, chemical pneumonitis and respiratory distress syndrome[1]. These complications contribute to a significant increase in morbidity and mortality rates, prolonging, on average, 5 to 9 days the hospitalization time of patients and significantly increasing hospital costs[3]. In Brazil, it is the fourth leading cause of hospitalization, with the elderly being more affected, due to the increased incidence of dysphagia and gastroesophageal reflux in this age group[7]
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