Risk factors for pneumonia in a nursing home resident (page 1205):
(1) poor functional status
(2) presence of nasogastric or feeding tube
(3) difficulty swallowing
(4) confusion, agitation, or wandering
(5) falls
(6) chronic lung disease
(7) tracheostomy
(8) advancing age
(9) male gender
Many of the risk factors are associated with either aspiration, dementia, or severe disability.
where:
• No mention is made of (1) vaccination status relative for pneumococcal vaccine, (2) secondary pneumonia following an outbreak of influenza, (3) immunosuppression or chronic steroid use, or (4) smoking status in patients with chronic lung disease. However, the first 2 items are discussed later in the paper under methods to reduce pneumonia.
• Other interventions to reduce pneumonia include good oral hygiene. Many of the conditions listed above are associated with poor oral hygiene.
• The age limit for advancing age is not specified. I will use > 80 in the implementation.
