Background:
Hospital-acquired pneumonia (HAP) is a common and potentially preventable cause of morbidity and mortality in older inpatients. Dysphagia, poor oral hygiene, and inadequate communication of swallowing risk are key contributors, yet routine dysphagia screening is not standard practice in general geriatric wards.
Aim:
To evaluate the impact of a multidisciplinary intervention targeting dysphagia recognition, oral care, and communication on HAP in an acute geriatrics ward.
Methods:
The DYSCO-HAP Program was implemented as a single-centre quality assurance initiative on a 28-bed acute geriatrics ward at Westmead Hospital from 14 October 2024. Interventions included a nurse-led dysphagia screening tool completed at the first meal or with clinical deterioration, colour-coded bedside signage indicating swallowing risk, and a standardised oral hygiene protocol. Education was provided to nursing and medical staff. Outcomes from pre-intervention (May–September 2024) and post-intervention (October 2024–February 2025) periods were compared using audit and electronic medical record data. Primary outcomes were HAP incidence and in-hospital mortality.
Results:
A total of 517 patients were included (300 pre-intervention, 217 post-intervention). HAP incidence increased from 5.0 to 8.8 per 100 admissions post-intervention, while in-hospital mortality decreased from 15.3 to 7.4 deaths per 100 admissions. Dysphagia screening compliance was 67.1%, with 18.7% identified as high risk.
Conclusion:
The DYSCO-HAP Program demonstrates the feasibility of low-cost, Multidisciplinary-led strategies to improve dysphagia recognition and care processes in acute geriatrics.