Factors leading to aspiration pneumonia among the Hospitalized

patients

A synopsis submitted by HIRA MARYAM

Registration No. 70134713

In partial fulfillment of the award for

BS Nursing 2-year

Supervisor I: Assist. prof Madiha Mukhtar

(Master of science in Nursing)

Supervisor II: Assist. prof Iqra shahzadi

(Master of science in Nursing)

Lahore School of Nursing

Faculty of Allied Health Sciences
THE UNIVERSITY OF LAHORE
(2022 TO 2024)

1
LIST OF CONTENTS
SR.NO CONTENT PAGE.NO
1. INTRODUCTION 4-7
2 PROBLEM STATEMENT 8
3. SIGNIFICANCE 8

4. AIM /PURPOSE OF THE STUDY 8

5. OBJECTIVES/STUDY QUESTIONS 9

6. LITERATURE REVIEW 10-13

7. MATERIAL AND METHODS 14

8. STUDY DESIGN 14

9. SAMPLING TECHNIQUE 14

10. TARGET POPULATION 14

11. STUDY SETTING 14

12. STUDY DURATION 14

13. SAMPLING SIZE 14

14. STUDY TOOL 15

15. INCLUSION CRITERIA 15

16. EXCLUSION CRITERIA 15

17. DATA COLLECTION 15

18. DATA ANALYSIS 15

19. ETHICAL CONSIDERATION 15

20. OPERATIONAL DEFINITION 16

21. ANALYSIS 17-31

22. DISCUSION 32-35

23. REFERENCES 36-38

24. APPENDICIES 39

25. DEMOGRAPHIC DATA 40

26. QUESTIONNAIRE 41-43

Abstract

2
Aim. The aim of the study was to Factors leading to aspiration pneumonia among the

Hospitalized patients.

Methodology. A descriptive cross-sectional research study design was used. Study used

purposive sampling technique. The study population was staff nurses and sample size was 157.

Results. The study was descriptive cross-sectional so descriptive statistics was applied,

frequency distribution was calculated, data normality was checked. The study reported that the

participants with low respond were 106 (67.5%), the participants with moderate respond were 35

(22.3%) and participants with high respond were 16 (10.2%).

Conclusion. The study concluded that the majority of nurses having poor respond regarding

Factors leading to aspiration pneumonia among the Hospitalized patients.

Key words: Factors leading to aspiration pneumonia among the Hospitalized patients.

3
 Factors leading to aspiration pneumonia among the Hospitalized

patients.

CHAPTER: NO 1

INTRODUCTION

1.1 Background

The term "aspiration" refers to the inhalation of stomach or oropharyngeal contents into

the lower respiratory tract and larynx (Kosutova & Mikolka, 2021). Aspiration simply means to

draw anything in or out through suction(De Haas, 2021). It is crucial to know that desire is a

typical occurrence that could fall within the range of typical physiology. (Elmahdi, Eisa, &

Omer, 2023). A large proportion of healthy people with normal mental status aspirate during

sleep based on the detection of radiolabeled oral dyes in the lungs of healthy volunteers (Neill &

Dean, 2019).

A particular kind of lung infection known as aspiration pneumonia is brought on by

inhaling foreign objects into the lungs, such as food, saliva, or vomit. (Shabeera, Mounika,

Rasheed, Rahin, & Hemanth, 2024). Inhaled colonized oropharyngeal debris can cause aspiration

pneumonia, which typically affects those with compromised swallowing mechanics. (Almirall,

Boixeda, de la Torre, & Torres, 2021). The main way that bacteria enter the lungs is by

aspirating colonized secretions from the oropharynx. (Kosutova & Mikolka, 2021). Haemophilus

influenza and Streptococcus pneumonia do, in fact, colonies the oropharynx and nasopharynx

prior to aspiration, which prevents community-acquired pneumonia. (Demars et al., 2022).

However, the phrase "aspiration pneumonia" particularly describes the formation of a

4
radiographically noticeable infiltrate in those who are more likely to experience oropharyngeal

aspiration. (Almirall et al., 2021). Mendelson's condition, also known as aspiration pneumonitis,

is a chemical injury brought on by breathing in sterile stomach contents, while aspiration

pneumonia is an infectious process brought on by breathing in oropharyngeal secretions

contaminated with pathogenic microorganisms.(Kosutova & Mikolka, 2021).

Aspiration pneumonia is the leading cause of death for individuals suffering from

dysphagia brought on by neurologic illnesses; this condition affects between 300,000 and

600,000 persons annually in the US. (Seo et al., 2021). Additionally frequent among nursing

home residents is aspiration pneumonia.(Chen, Kent, & Cui, 2021). Aspiration pneumonia

occurred in 18% of patients with nursing home-acquired pneumonia and 5% of controls with

community-acquired pneumonia in one research. Ten percent or so of hospitalized patients after

a drug overdose develop aspiration pneumonitis.(Lin et al., 2020). It is also a known

complication of general anesthesia, occurring in about 1 out of every 3000 surgeries under

anesthesia and contributing to 10 to 30 percent of anesthesia-related deaths.(Li & Sumathi,

2018). Small volumes of oropharyngeal secretions are aspirated during sleep by around half of

all healthy adults(Yamaguchi, Mikushi, & Ayuse, 2019). According to multiple studies,

aspiration accounts for 7–24% of cases of CAP. As we have previously shown, aspiration

pneumonia can be identified in about 60% of hospitalized patients with CAP. (Marin-Corral et

al., 2021).

Aspiration frequently results from poor swallowing, which makes it possible for stomach

or oral contents, or both, to reach the lung, particularly in those with weak cough reflexes.

(McCarty & Chao, 2021). Dysphagia, head, neck, and esophageal cancer, esophageal stricture

and motility abnormalities, chronic obstructive pulmonary disease, and seizures are associated

5
with large-volume aspiration. (Kosutova & Mikolka, 2021). In a research comprising 146,552

hospitalized patients, antipsychotic medicines raised the incidence of aspiration pneumonia by a

factor of 1.5. (Herzig et al., 2017). High-volume aspiration may result after enteral feeding,

particularly if it is accompanied by poor coughing, changed mental status, and stomach

dysmotility (Kollmeier, Keenaghan, & Doerr, 2021). In three studies including more than 5,000

patients who underwent enteral feeding following a stroke.(Juan et al., 2020). In the first two to

three weeks following the stroke, early tube feeding increased survival when compared to no

feeding. (Hota et al., 2021). Comparing nasogastric tube feeding to percutaneous enteral tube

feeding, better survival and functional outcomes were found. (Veronese et al., 2020). Currently,

enteral feeding tubes are not advised for dementia patients. (Lee et al., 2021).

Aspiration pneumonia can result from any illness that raises the volume or bacterial load

of oropharyngeal secretions in a person with compromised defenses.(Palmer & Padilla, 2022). In

fact, there is a direct link between the amount of aspirate and the development of pneumonia in

stroke patients who are having their swallowing evaluated(Schwarz, Coccetti, Murdoch, &

Cardell, 2018). Aspiration pneumonia risk may be raised by variables that raise the bacterial load

and the chance of oropharyngeal colonization by potentially pathogenic organisms. (Hong et al.,

2018). Aspiration pneumonia can be distinguished from community-acquired pneumonia

primarily by these hazards. But there is a lot of overlap.(Rodriguez & Restrepo, 2019). For

example, compared to age-matched controls, older individuals in otherwise good health who

develop community-acquired pneumonia have a considerably increased prevalence of silent

aspiration.(Aqeel & Jacobs, 2018).

Oropharyngeal aspiration is more common in patients with neurologic dysphagia,

disruption of the gastroesophageal junction, or structural abnormalities of the upper aero

6
digestive tract.(McCarty & Chao, 2021). Due to the increasing prevalence of dysphagia and

gastric reflux in this demographic, older people are at a relatively high risk of aspiration.

(Thiyagalingam, Kulinski, Thorsteinsdottir, Shindelar, & Takahashi, 2021). Furthermore, elderly

people often have inadequate dental care, which can lead to the colonization of the oropharynx

by respiratory tract pathogens such as Enterobacteriaceae (Scannapieco, 2023).

Clinical aspects might range from the absence of symptoms to respiratory failure with

significant distress. Acute, subacute, or slowly increasing clinical effects can occur. (Singh &

Wijdicks, 2021). Aspiration into the lung can damage the lung parenchyma or the airway,

leading to asthma, bronchospasm, and a persistent cough.(Kosutova & Mikolka, 2021).

Aspiration into the lung parenchyma is the subject of this discussion. Aspiration can result in

bacterial pneumonia, aspiration of bland material (such as blood or the contents of a feeding

tube), or aspiration that causes chemical pneumonitis(Longo, Mandell, & Niederman, 2019).

Aspiration pneumonia is diagnosed based on a distinctive clinical history (witnessed macro

aspiration), risk factors, and consistent chest radiography findings. (Abe et al., 2020).

Patients with aspiration pneumonia should definitely receive antibiotic therapy(Simpson

et al., 2023). The environment in which the aspiration occurs and the patient's overall health

should be taken into consideration when selecting an antibiotic. (Rodriguez & Restrepo, 2019).

Fluoroquinolones, piperacillin, and third-generation cephalosporin’s are examples of antibiotics

that are active against gram-negative pathogens and are typically needed. (Breijyeh, Jubeh, &

Karaman, 2020). Most patients with aspiration pneumonia do not respond well to penicillin and

clindamycin, which are sometimes referred to as the conventional antibiotic treatments for

aspiration pneumonia.(Bowerman, Zhang, & Waite, 2018) Antibiotics with particular anaerobic

activity are not always necessary and may only be recommended for individuals with severe

7
periodontal disease, foul-smelling sputum, or radiographs showing necrotizing pneumonia or

lung abscess. (Mani, 2018).

1.2 Problem statement

Aspiration pneumonia is a type of lung infection that occurs when foreign material, such as

food, saliva, or vomit, is inhaled into the lungs. It often affects individuals with impaired

swallowing mechanisms. Aspiration pneumonia remains a persistent and concerning health issue

among hospitalized patients, posing a substantial burden on both patients and healthcare systems.

Despite advancements in medical care, the prevalence of aspiration pneumonia within the

hospital setting continues to raise questions. Hospitalized patients, often dealing with complex

medical conditions. So the aim of the study to identify the leading factor of aspiration pneumonia

among the hospitalized patients.

1.3 Significance:

This study will be helpful to identify the Factors leading to aspiration pneumonia among the

Hospitalized patients. This study will be describing the basic factor of the aspiration pneumonia

and their complication among hospitalized patient. The study will be also reveal that how many

number of nurses have idea regarding aspiration pneumonia.

1.4 Aim of the study:

To identify the Factors leading to aspiration pneumonia among the Hospitalized patients

1.5 Purpose of the study:

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purpose of the study to identify Factors leading to aspiration pneumonia among the Hospitalized

patients

1.6 Research Objectives:

To highlight the Factors leading to aspiration pneumonia among the Hospitalized

patients

1.7 Research Question:

What is the Factors leading to aspiration pneumonia among the Hospitalized patients? \

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 CHAPTER: NO 2

LITERATURE REVIEW

The word aspiration simply refers to the drawing in or out of a substance by suction. It is

important to understand that aspiration is a common event that may lie within the spectrum of

normal physiology. A large proportion of healthy people with normal mental status aspirate

during sleep based on the detection of radiolabeled oral dyes in the lungs of healthy volunteers

A cross-sectional descriptive study was conducted by Zhao et al in 2023 in china. the

study aimed was to explore the risk factors and delineate the antibiotic usage for Aspiration

pneumonia. The study results showed that cerebrovascular disease (OR: 3.1, 95% CI: 2.8–3.5),

dementia (OR: 2.0, 95% CI: 1.8–2.1), vomiting (OR: 1.4, 95% CI: 1.2–1.7), Parkinson’s disease

(OR: 2.1, 95% CI: 1.8–2.4), and epilepsy (OR: 3.2, 95% CI: 2.8–3.7) were associated with an

increased risk of AP. 92.8% of the AP patients received antibiotic therapy. Among them, patients

treated with broad-spectrum antibiotics, antibiotics for injection, and combined antibiotics

accounted for 93.3%, 97.9%, and 81.7%, respectively. The conclusion mentioned that Older age,

male, and several comorbidities were independent risk factors for AP, and combined antibiotics

treatments are common, which merits attention in accurate detection of AP in a high-risk

population.(Zhao et al., 2023).

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 The Qusai experimental study was conducted byMarin-Corral et al in 2021 in spain the

study aimed was Aspiration community-acquired pneumonia (ACAP) and communityacquired

pneumonia (CAP) in patients with aspiration risk factors. The result revealed that Risk factors

independently associated with ACAP were male, bedridden, underweight, a nursing home

resident, and having a history of stroke, dementia, mental illness, and enteral tube feeding.

Among non-ACAP patients, 1,709 (70.8%) had CAP/AspRF+ and 704 (29.2%) had

CAP/AspRF-. Microbiology patterns including anaerobes were similar between CAP/AspRF-,

CAP/AspRF+ and ACAP (0.0% vs. 1.03% vs. 1.64%). Patients with severe ACAP had higher

rates of total Gram-negative bacteria (64.3% vs. 44.3% vs. 33.3%, p=0.021) and lower rates of

total Gram-positive bacteria (7.1% vs. 38.1% vs. 50.0%, p50% in all groups) independent of

AspRFs or ACAP received specific or broad-spectrum anti-anaerobic coverage antibiotics

(Marin-Corral et al., 2021).

The another study by Suzuki et al in 2021 in japan. The aime was to describe the latest

trends in pneumonia hospitalizations, especially aspiration pneumonia (AP) cases, we assessed

the clinical records of pneumonia patients. The result identify hospitalization, AP patients had

extended fasting periods, more swallowing assessments and interventions, longer hospitalization,

and higher in-hospital mortality rate than non-AP patients. A total of 7% and 2% AP patients

underwent video endoscopy and video fluorography respectively. In multivariate analysis, lower

BMI, lower C-reactive protein, a lower ratio of homestay before hospitalization, a higher

complication rate of cerebrovascular disease, dementia, and neuromuscular disease were noted as

a characteristic of AP patients. Swallowing interventions were performed for 51% of the AP

patients who had been hospitalized for more than two weeks. In univariate analysis, swallowing

intervention improved in-hospital mortality. Lower AP recurrence before hospitalization and a

11
lower ratio of homestay before hospitalization were indicated as characteristics of AP patients of

the swallowing intervention group from multivariate analysis. Change in dietary pattern from

normal to modified diet was observed more frequently in the swallowing intervention group. The

conclusion mentioned that AP accounts for 38.4% of all pneumonia cases in acute care hospitals

in Northern Japan. The use of swallowing evaluations and interventions, which may reduce the

risk of dysphagia and may associate with lowering mortality in AP patients, is still not

widespread (Suzuki et al., 2021).

According to descriptive study of the Oi et al in 2024 in japan. . the study aimed was to

determine which risk factors for aspiration are associated with death or prolonged

hospitalization. The results describe that the hospital death increased as the number of risk

factors for aspiration increased. In the multivariate analysis, male, impaired consciousness,

acidemia, elevated blood urea nitrogen, and bedridden status before the onset of pneumonia were

associated with in-hospital death (odds ratio [OR]: 2.5, 2.5, 3.6, 3.1, and 2.6; 95% confidence

interval [CI]: 1.6–4.1, 1.4–4.2, 1.6–8.0, 1.9–5.0, and 1.6–4.2 respectively). In the Cox regression

analysis, these factors were also associated with in-hospital death. None of the vital signs at

admission were associated. Tachycardia, elevated blood urea nitrogen, hyponatremia, and

bedridden status were associated with hospitalization for >27 days (OR: 4.1, 2.3, 4.3, and 2.9;

95% CI: 1.3–12.9, 1.5–3.4, 2.0–9.4, and 2.0–4.0, respectively). Conclusion of the study discuss

Blood sampling findings and bedridden status are useful for predicting in-hospital mortality and

long-term hospitalization in patients with pneumonia and any risk factor for aspiration (Oi et al.,

2024).

The another study conducted by Shin, Lebovic, & Lin, in 2023 in Canada. The primary

objective of the study was to examine independent patient factors that are associated with

12
mortality in those requiring acute admission for aspiration pneumonia at a tertiary institution.

The results showed A total of 634 patients were included in this study. 134 (21.1%) patients died

during hospitalization with an average age of 80.3 ± 13.4. The in-hospital mortality did not

change significantly over the ten-year period (p = 0.718). Patients who died had longer LOS with

a median length of 10.5 days (p = 0.012). Age [Odds Ratio (OR) 1.72, 95% Confidence Interval

(95% CI) 1.47–2.02, p < 0.05] and invasive mechanical ventilation (OR 2.57, 95% CI 1.54–

4.31, p < 0.05) were independent predictors of mortality while female gender was found to be a

protective factor (OR 0.60, 95% CI 0.38–0.92, p = 0.02). Elderly patients had five times higher

risk of dying during their hospital course when compared to younger patients [Hazard Ratio

(HR) 5.25, 95% CI 2.99–9.23, p < 0.05). Elderly patients are a high-risk population for

developing aspiration pneumonia and are at higher risk of death when hospitalized for this

condition. Conclusion of the study clarify This warrants improved preventative strategies in the

community. Further studies involving other institutions and creating a Canada-wide database are

required (Shin, Lebovic, & Lin, 2023).

The research published by The purpose of this study was to evaluate long-term mortality

and its associated factors in patients with aspiration pneumonia. Results of the study describe A

total of 441 (80.2%) patients died during a median follow-up of 50.7 weeks. The 1-, 3-, and 5-

year mortality rates were 49.0%, 67.1%, and 76.9%, respectively. Multivariate analysis identified

5 risk factors for 1-year mortality of male sex [hazard ratio (HR) 1.533, P = .003], low body

mass index (HR 0.934, P = .002), hypoalbuminemia, anemia (0.973, P = .032), and mechanical

ventilation (HR 2.052, P < .001), which were also independent prognostic factors for 5-year

mortality. During the follow-up period, 133 (24.2%) patients experienced recurrent

aspiration pneumonia. However, Kaplan-Meier analysis showed no significant differences in

13
survival curves between patients with single and recurrent aspiration pneumonia (P = .371).the

study conclusion mentioned that the Long-term prognosis of aspiration pneumonia was poor as a

result of underlying morbidity instead of the aspiration pneumonia itself. Our findings suggest

that prognostic indices for patients with aspiration pneumonia including the patient's underlying

conditions should be devised (Yoon et al., 2019).

CHAPTER: NO 3

METHODOLOGY

3.1 Study design

A descriptive cross sectional study design was conducted to assess the Factors leading to

aspiration pneumonia among the Hospitalized patient.

3.2 Sampling technique

The purposive sampling techniques was used.

3.3 Target population

The study population was staff nurses of Jinnah hospital Lahore.

3.4 Study setting

The setting of the study was jinnah hospital lahore.

3.5 Study duration

The duration of this study was 4 months

3.6 Sampling size

The study sample was 157 calculated through slovin’s formula.

N
n=
1+ Ne 2

14
 n = sample size

N= population size

e = margin of error

260
n=
1+ 260 ( 0.05 ) 2

260
n=
1+ 260(0.0025)

260
n=
1+ 0.65

260
n=
1.657

n= 157

3.7 Study tool

An adapted questionnaire of factors leading to aspirate pneumonia was used to gather the

information from the study sample.

3.8 Inclusion criteria

 The study was included all the nurses who have at least more than two year

experience

 Data was gather from all staff nurses working in Emergency, ICUs and CCUs

department of jiinah hospital.

3.9 Exclusion criteria

 All the students nurses and intership nurses

 Those nurses who are new in the job

 Head nurses was excluded in the study.

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3.10 Data collection

Data was collected an adapted questionnaire of Factors leading to aspiration pneumonia

among the Hospitalized patient.

3.11 Data analysis

After collecting data, the data was compute analyze by software program (SPSS) version

(22).

3.12 Ethical consideration

The ethical considration was followed which is organize by the Lahore school of nursing.

The participant all the confendentiality was ensure any participant who are not willing to

participate can be withdraw from the study at any time. There will be no potential harm and

potential benefits for the study.

3.13 Operational definition

The knowledge score was calculated through adapted knowledge questionnaire consist

of 10. The participants who tick right option was given 1 mark. The participants who scored

above (>80%) of knowledge were consider to have good knowledge of aspiration pneumonia.

Whereas who score between (60-80%) were consider moderate knowledge. Those who scored

below (<60%) were consider poor knowledge

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 CHAPTER: NO 4

ANALYSIS

Table: no. 1

Age

Frequency Percent Valid Percent Cumulative

Percent

26-30 68 43.3 43.3 43.3

31-35 61 38.9 38.9 82.2

Valid
36-40 28 17.8 17.8 100.0

Total 157 100.0 100.0

Graph no. 1

Table no: 1 shows that from total no of participants 68 (43.3%) was with the age group of 26-30,

and those with age group 31-35 were 61(38.9%), 36-40 age group participants 28 (17.8%).

17
Table no 2

gender

Frequency Percent Valid Percent Cumulative

Percent

female 98 62.4 62.4 62.4

Valid male 59 37.6 37.6 100.0

Total 157 100.0 100.0

Graph no 2

Table no 2. Identify that the total no of participants the females were 98(62.4%) and the male

were 59 (37.6%).

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Table no 3

marital status

Frequency Percent Valid Percent Cumulative

Percent

single 104 66.2 66.2 66.2

Valid married 53 33.8 33.8 100.0

Total 157 100.0 100.0

Graph no 3

Table no 3. From the total number of participants, the single was 104(66.2%) and married

53(33.8%).

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Table no 4
experience

Frequency Percent Valid Percent Cumulative

Percent

1-5 year 52 33.1 33.1 33.1

5-10 year 63 40.1 40.1 73.2

Valid
11-15 year 42 26.8 26.8 100.0

Total 157 100.0 100.0

Graph no 4

Table no 4. Revealed that the group of 1-5 year were 52(33.1%), group 6-10 year 653(4.1%),

group 11-15 year 42(26.8%).

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Table no 5

qualification

Frequency Percent Valid Percent Cumulative

Percent

diploma in General nursing 62 39.5 39.5 39.5

post RN 65 41.4 41.4 80.9

Valid
BSN Generic 30 19.1 19.1 100.0

Total 157 100.0 100.0

Graph no 5

Table No.5 the participants from Diploma nursing were 62(39.5%), participants from Post RN

65(41.4%) and participants from BSN were 30(19.1%).

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Table no 6

department

Frequency Percent Valid Percent Cumulative

Percent

emergency 36 22.9 22.9 22.9

ICU 28 17.8 17.8 40.8

CCU 14 8.9 8.9 49.7

Valid
Medical ward 52 33.1 33.1 82.8

surgical ward 27 17.2 17.2 100.0

Total 157 100.0 100.0

Graph no 6

Table no.6 identify that the participants of from emergency were 36(22.9%), ICU participants

28(17.8%), CCU participants 14(8.9%), Medical ward 52(33.1%), and Surgical ward participants

were 27(17.2%).

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Table no 7
Test of Normality

Tests of Normality
Kolmogorov-Smirnova Shapiro-Wilk

Statistic df Sig. Statistic df Sig.

factor .295 157 .000 .835 157 .000

a. Lilliefors Significance Correction

Table no.7 shows the value of kolmogorove is .000 which is less than .05 and indicating as

insignificant so the data is not normally distributed

Table no 8

GCS
Frequency Percent Valid Percent Cumulative
Percent

<8 91 58.0 58.0 58.0

Valid 9-12 66 42.0 42.0 100.0

Total 157 100.0 100.0

Table no: 8 showes that from the total no of participants who participated in study and respond to

the question that the ‘‘GCS” those who tick the <8 option were 91(58.0%), and those who tick

the 9-12 option were 66(42.0%).

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Table no 9
Stroke effected body part
Frequency Percent Valid Percent Cumulative
Percent

bilateral 31 19.7 19.7 19.7

Valid unilateral 126 80.3 80.3 100.0

Total 157 100.0 100.0

Table no: 9 showes that from the total no of participants who participated in study and respond to

the question that the ‘‘stroke effected body part” those who tick the bilateral option were

31(19.7%), and those who tick the unilateral option were 125(80.3%).

Table no 10

Types of stroke
Frequency Percent Valid Percent Cumulative
Percent

ischemic 61 38.9 38.9 38.9

Valid hemorrhagic 96 61.1 61.1 100.0

Total 157 100.0 100.0

Table no: 10 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘types of stroke” those who tick the ischemic option were 61(38.9%),

and those who tick the hemorrhagic option were 96(61.1%).

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Table no 11
hypertension
Frequency Percent Valid Percent Cumulative
Percent

Yes 112 71.3 71.3 71.3

Valid No 45 28.7 28.7 100.0

Total 157 100.0 100.0

Table no: 11 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘hypertension” those who tick the yes option were 112(71.3%), and

those who tick the no option were 45(28.7%).

Table no 12

Heart disease
Frequency Percent Valid Percent Cumulative
Percent

yes 116 73.9 73.9 73.9

Valid no 41 26.1 26.1 100.0

Total 157 100.0 100.0

Table no: 12 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘heart disease” those who tick the yes option were 116(73.9%), and

those who tick the no option were 41(26.1%).

25
Table no 13
diabetes melliatus
Frequency Percent Valid Percent Cumulative
Percent

yes 104 66.2 66.2 66.2

Valid no 53 33.8 33.8 100.0

Total 157 100.0 100.0

Table no: 13 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘diabetes melliatus” those who tick the yes option were 104(66.2%), and

those who tick the no option were 53(33.8%).

Table no 14

Vomiting
Frequency Percent Valid Percent Cumulative
Percent

Valid yes 157 100.0 100.0 100.0

Table no: 14 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘vomiting” those who tick the yes option were 157(100%).

Table no 15
dysphagia
Frequency Percent Valid Percent Cumulative
Percent

Valid yes 157 100.0 100.0 100.0

Table no: 15 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘dysphagia” those who tick the yes option were 157(100%).

26
Table no 16
seizure

Frequency Percent Valid Percent Cumulative

Percent

yes 117 74.5 74.5 74.5

Valid no 40 25.5 25.5 100.0

Total 157 100.0 100.0

Table no: 16 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘seizure” those who tick the yes option were 117(74.5%), and those who

tick the no option were 40(25.5%).

Table no 17
hyperglycemia
Frequency Percent Valid Percent Cumulative
Percent

yes 97 61.8 61.8 61.8

Valid no 60 38.2 38.2 100.0

Total 157 100.0 100.0

Table no: 17 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘hyperglycemia” those who tick the yes option were 97(61.8%), and

those who tick the no option were 60(38.2%).

27
Table no 18
Co-morbidities

Frequency Percent Valid Percent Cumulative

Percent

yes 119 75.8 75.8 75.8

Valid no 38 24.2 24.2 100.0

Total 157 100.0 100.0

Table no: 18 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘co-morbidities” those who tick the yes option were 119(75.8%), and

those who tick the no option were 38(24.2%).

Table no 19

site
Frequency Percent Valid Percent Cumulative
Percent

oropharynx and 157 100.0 100.0 100.0

Valid
hypopharynx
Table no: 19 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘site” those who tick the oropharynx and hypopharynx option were

157(100%),

Table no 20

stage

Frequency Percent Valid Percent Cumulative

Percent

early 115 73.2 73.2 73.2

Valid advanced 42 26.8 26.8 100.0

Total 157 100.0 100.0

28
Table no: 20 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘stage” those who tick the early option were 115(73.2%), and those who

tick the advanced option were 42(26.8%).

Table no 21

smoking
Frequency Percent Valid Percent Cumulative
Percent

yes 80 51.0 51.0 51.0

Valid no 77 49.0 49.0 100.0

Total 157 100.0 100.0

Table no: 20 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘smoking” those who tick the yes option were 80(51.0%), and those who

tick the no option were 77(49.0%).

Table no 21
Baseline swallowing capacity

Frequency Percent Valid Percent Cumulative

Percent

Valid decreased 157 100.0 100.0 100.0

Table no: 21 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘baseline swallowing capacity” those who tick the decreased option were

157(100%).

29
Table no 22

Treatment planned

Frequency Percent Valid Percent Cumulative

Percent

radial 69 43.9 43.9 43.9

Valid palliative 88 56.1 56.1 100.0

Total 157 100.0 100.0

Table no: 22 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘treatment planned” those who tick the radial option were 69(43.9%),

and those who tick the no option were 88 (56.1%).

Table no 23

Surgery with adjuvant therapy

Frequency Percent Valid Percent Cumulative

Percent

yes 110 70.1 70.1 70.1

Valid no 47 29.9 29.9 100.0

Total 157 100.0 100.0

Table no: 23 showes that from the total no of participants who participated in study and respond

to the question that the ‘‘surgery with adjuvant therapy” those who tick the yes option were

110(70.1%), and those who tick the no option were 47(29.9%).

30
Table no 24

question12

Frequency Percent Valid Percent Cumulative

Percent

low 106 67.5 67.5 67.5

moderate 35 22.3 22.3 89.8

Valid
high 16 10.2 10.2 100.0

Total 157 100.0 100.0

The table no.24 shows that participants with low respond were 106 (67.5%), the participants with

moderate respond were 35 (22.3%) and participants with high respond were 16 (10.2%).

31
 Chapter: no 5

Discussion and conclusion

The current study was aimed to identify Factors leading to aspiration pneumonia among

the Hospitalized patients. The study was descriptive cross-sectional and used descriptive

statistics, frequency distribution was applied data normality was checked, data reliability and

validity was ensured by the 1 st author of the study tool as study used the adopted version of

questionnaire.

Participants who participated in the study 68 (43.3%) was with the age group of 26-30,

and those with age group 31-35 were 61(38.9%), 36-40 age group participants 28 (17.8%).

Majority females were 98(62.4%) and the male were 59 (37.6%). Similarly, single was

104(66.2%) and married 53(33.8%). Participants with the experience group of 1-5 year were

52(33.1%), group 6-10 year 653(4.1%), group 11-15 year 42(26.8%). the participants with

Diploma nursing were 62(39.5%), participants from Post RN 65(41.4%) and participants from

BSN were 30(19.1%). the study participants working in emergency were 36(22.9%), ICU

participants 28(17.8%), CCU participants 14(8.9%), Medical ward 52(33.1%), and Surgical ward

participants were 27(17.2%).

participants who participated in study and respond to the question that the ‘‘GCS” those who tick

the <8 option were 91(58.0%), and those who tick the 9-12 option were 66(42.0%). this revealed

that the majority of the participants were belongs to good knowledge. participants who

participated in study and respond to the question that the ‘‘stroke effected body part” those who

tick the bilateral option were 31(19.7%), and those who tick the unilateral option were

125(80.3%), %). this showed that the majority of the participants were belongs to good

32
knowledge. participated in study and respond to the question that the ‘‘types of stroke” those

who tick the ischemic option were 61(38.9%), and those who tick the hemorrhagic option were

96(61.1%), this showed that the majority of the participants were belongs to good knowledge.

participated in study and respond to the question that the ‘‘hypertension” those who tick the yes

option were 112(71.3%), and those who tick the no option were 45(28.7%), this showed that the

majority of the participants were belongs to good knowledge. participated in study and respond

to the question that the ‘‘heart disease” those who tick the yes option were 116(73.9%), and

those who tick the no option were 41(26.1%), this identify that the majority of the participants

were belongs to good knowledge. participated in study and respond to the question that the

‘‘diabetes melliatus” those who tick the yes option were 104(66.2%), and those who tick the no

option were 53(33.8%), this identify that the majority of the participants were belongs to good

knowledge. participants who participated in study and respond to the question that the

‘‘vomiting” those who tick the yes option were 157(100%), this identify that the majority of the

participants were belongs to good knowledge. participants who participated in study and respond

to the question that the ‘‘dysphagia” those who tick the yes option were 157(100%), this showed

that the majority of the participants were belongs to good knowledge. participants who

participated in study and respond to the question that the ‘‘seizure” those who tick the yes option

were 117(74.5%), and those who tick the no option were 40(25.5%), %), this showed that the

majority of the participants were belongs to good knowledge. participants who participated in

study and respond to the question that the ‘‘hyperglycemia” those who tick the yes option were

97(61.8%), and those who tick the no option were 60(38.2%). this showed that the majority of

the participants were belongs to good knowledge. participants who participated in study and

respond to the question that the ‘‘co-morbidities” those who tick the yes option were

33
119(75.8%), and those who tick the no option were 38(24.2%). this showed that the majority of

the participants were belongs to good knowledge. participants who participated in study and

respond to the question that the ‘‘site” those who tick the oropharynx and hypopharynx option

were 157(100%), this showed that the majority of the participants were belongs to good

knowledge. participants who participated in study and respond to the question that the ‘‘stage”

those who tick the early option were 115(73.2%), and those who tick the advanced option were

42(26.8%), this showed that the majority of the participants were belongs to good knowledge.

participants who participated in study and respond to the question that the ‘‘smoking” those who

tick the yes option were 80(51.0%), and those who tick the no option were 77(49.0%). this

showed that the majority of the participants were belongs to good knowledge. participants who

participated in study and respond to the question that the ‘‘baseline swallowing capacity” those

who tick the decreased option were 157(100%), this showed that the majority of the participants

were belongs to good knowledge. participants who participated in study and respond to the

question that the ‘‘treatment planned” those who tick the radial option were 69(43.9%), and

those who tick the palliative option were 88 (56.1%), this showed that the majority of the

participants were belongs to good knowledge. participants who participated in study and respond

to the question that the ‘‘surgery with adjuvant therapy” those who tick the yes option were

110(70.1%), and those who tick the no option were 47(29.9%), this showed that the majority of

the participants were belongs to good knowledge. participants with low respond were 106

(67.5%), the participants with moderate respond were 35 (22.3%) and participants with high

respond were 16 (10.2%), This shows that the majority of nurses were poor knowledge.

34
5.1 CONCLUSION

The current study concluded that the Factors leading to aspiration pneumonia among the
Hospitalized patient was poor respond of the nurses. This is the need of the time to educate
nurses and bring better knowledge and practice regarding the aspiration pneumonia, so the risk
factor for aspiration pneumonia is to decreased patients care can improve and the side effects due
to malpractice should be minimize. there is intense need to providing education and conduct
trainings programs for enhancing the knowledge and improving the practice of nurses regarding
oxygen therapy administartion to the critical ill patients.

5.2 LIMITATION

1. The current study used cross-sectional study design to identify the Factors leading to

aspiration pneumonia among the Hospitalized patient was poor respond of the nurses.

2. The study is only focus to Factors leading to aspiration pneumonia among the

Hospitalized patient was poor respond of the nurses.

3. The study sample was too small to generalize the study finding.

5.3 RECOMENDATION
 The current study investigate level of Factors leading to aspiration pneumonia among

the Hospitalized patient was poor respond of the nurses. The future researcher can

work on the enhancement of knowledge and practice to conducted experimental study

by which they can asses knowledge and practice to give the intervention for

enhancement of knowledge and practice towards aspiration pneumonia among nurses.

35
  The future researchers can play a part to implement education programs and

familiar the nurses regarding the risk factor of aspiation pneumonia through

workshop, training programs, seminar, lecture and research.

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38
 APPENDICIES

APPENDIX: Questionnaire
Dear participation.
You are invited to participate in a research study conducted by “Hira Maryam , Student of
post RN, Year II -Semester II, Lahore school of Nursing”.
Purpose of study

The purpose of this study to “identify Factors leading to aspiration pneumonia among the
Hospitalized patient”.

Risks and discomforts

There is no risk associated with this study.
Potential benefits
The main potential benefits of my study to provide education for those nurses who care for
critical ill patients with the high risk of aspiration pneumonia and inform the management
regarding the knowledge, and practice towards aspiration pneumonia.
Protection of confidentiality
We will do everything we can to protect your privacy. Your identity will not be revealed in any
publication resulting from this study.
Voluntary participation
Your participation in this research study is voluntary. You may choose not to participate and you
may withdraw your consent to participate any time. You will not be penalized in any way should
you decide not you participate or to withdraw from this study.

39
 Demographic Characteristics.

 Respond by Tick Mark (✔) the most appropriate responses.

1. Age
 21-25
 26-30
 31-35
 36-40
2. Gender
 Female
 Male
3.Marital status
 Single
 Married
4.Experience
 1-5 year
 6-10 year
 11-15 year
 Above than 15 year
5.Qualification
 Diploma in General Nursing
 Post RN
 BSN (Generic)
 Master of Science in Nursing
6.Department
 Emergency
 ICU
 CCU
 Medical Ward
 Surgical Ward

40
Questionnaire of Factors leading to aspiration pneumonia

1. GCS

<8
9-12
>12

2. Stroke effected body part

Bilateral
Unilateral

3. Types of stroke

Ischemic
Hemorrhagic

4. hypertension

Yes
No

5. heart disease

Yes
No

6. Diabetes mellitus

Yes
No

7. Vomiting

Yes
No

8. dysphagia

Yes
No

41
9. Seizure

Yes
No

10. Hyperglycemia

Yes
No

11. co-morbidities

Yes
No

12. Site

Oropharynx and hypopharynx

Other

13. Stage

Early
Advanced

14. Smoking

Yes
No

15. Baseline swallowing capacity

Normal
Decreased

16. Treatment planned

Radial
Palliative

42
17. Surgery with adjuvant therapy

Yes
No

43