Aspiration Precautions

Aspiration Precautions 

Goal 
To provide guidelines for staff on precautions needed when aspiration is suspected or confirmed, ensuring resident safety and reducing the risk of aspiration of food or liquid into the lungs. 

Policy 
Aspiration Precautions will be utilized to reduce the risk of aspiration of food or liquid into a resident’s lungs. 

Procedure 

7. Designation and Notification: 

• A resident with significant risk of aspiration, which is not completely controlled by current diet modifications, will be designated as needing Aspiration Precautions by the Interdisciplinary Team. 

• The Dietary Department will be notified so that Aspiration Precautions can be included in the Geri Menu meal ticket “tray note”. 

8. Resident Positioning and Supervision: 

• Residents designated as needing Aspiration Precautions will be: 

• Positioned so that their head is at 90 degrees upright or as close as possible given the resident’s physical condition for meals, snacks, and ingestion of medication. 

• Supervised during meals/p.o. intake unless the Speech Language Pathologist (SLP) or MD indicates by order that supervision is not needed. 

• Encouraged to use their swallowing strategies during meals. 

• Positioned upright (at least 45 degrees upright) for at least 30 minutes after eating. 

• Provided with mouth care. 

9. Assessment and Discontinuation: 

• The resident must be assessed by the Speech Language Pathologist (SLP) for the Aspiration Precautions to be discontinued. 

10. Tube Feeding Precautions: 

• The head of the bed should never be lower than 30 degrees for residents receiving nutrition via tube feed. 

11. Monitoring and Reporting: 

• Any signs/symptoms of aspiration, e.g., increased temperature, abnormal lung sounds, increased coughing, will be further assessed and the MD notified. 

References: 

• Centers for Medicare & Medicaid Services (CMS), State Operations Manual (SOM) 

• Requirements of Participation for Nursing Homes, CMS 

• Evidence-Based Guidelines for Aspiration Precautions, American Speech-Language-Hearing Association (ASHA)