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aspiration algorithm, aspiration reduction, feeding protocol



  1. Bowman, Amy BSN, RN
  2. Greiner, Joseph E. MSN, RN
  3. Doerschug, Kevin C. MD
  4. Little, Susan B. MS, RD, LD, CNSD
  5. Bombei, Cheryl L. BSN, MSNc, RN
  6. Comried, Lynn M. MA, RN, CCRN


Aspiration pneumonia is a serious complication of mechanical ventilation and enteral tube feedings. It results in increased patient mortality, increased length of hospital stay, and increased healthcare costs. This article describes an evidence-based practice approach to the creation of an enteral feeding protocol and an aspiration risk reduction algorithm. These tools were piloted in a Medical Intensive Care Unit at a Midwest tertiary care center. Chart audits show an increase in the percentage of patients who reach their goal rate for enteral feedings from 78% to 85%. Reported aspiration pneumonias decreased from an average count of 4.8 patients per month to 4.3 per month and ventilator-associated pneumonia rates decreased from 6.8 to 3.2 per 1000 patient days.