Design: A quasi-experimental , comparative, longitudinal design is suggested for this study.

1. Do Aspiration Pneumonia Rates of Dysphagia Patients Change When Utilizing Chin Down VersusLiquid Thickener Methods of Swallowing? A Research Proposal. Jessica Anderson, Yen Do-Gorlero, Brando Gorlero, Johnathan Kerr, NajoodAzar, RN, PhD Background Proposed Methodology “One hospital admission for pneumonia is estimated to cost $7,166.” Robbins et al., 2008 Dysphagia is a significant problem in patients in the United States today with around 15 million Americans suffering from swallowing difficulties and 1 million new diagnoses annually (Vitalstim, 2011). Dysphagia is prevalent among the elderly. Half of all Americans over the age of 60 will experience difficulty swallowing (Vitalstim, 2011). Difficulty swallowing increases the risk for aspiration of food or liquids into the lungs. Foreign material in the lungs causes inflammation and can lead to bacterial growth, resulting in aspiration pneumonia (Robbins et al., 2008).            Two methods of preventing aspiration include the chin-down method and the use of liquid thickeners (Logemann et al., 2008). • Design: • A quasi-experimental, comparative, longitudinal design is suggested for this study. • Sample: • A purposive sample of patients diagnosed with dysphagia will be recruited using convenience sampling technique. A total sample size of 146 participants was determined using power analysis. To account for attrition and mortality, this research study will utilize 200 participants. • Recruitment: • Participants will be recruited from 13 San Bernardino County Hospitals. The inclusion parameters include newly diagnosed dysphagia patients immediately after speech pathology assessment and persons age 50 and older. The exclusion parameters will be participants with a previous history of dysphagia, comorbidities of traumatic brain injury, and Bell’s palsy. • Data Collection • Participants will be placed in either a chin down method group or liquid thickening group. The thickening of the feeding liquids will be carried out according to the manufacturer’s instructions. Nurses will prepare the thickened feeding liquids and chart their observations and assessments. Purpose The purpose is to compare the effectiveness of the chin down and liquid thickener feeding methods in avoiding the development of aspiration pneumonia in patients with dysphagia. Hypothesis There will be a significant difference in the effectiveness of liquid thickeners when compared with the chin down method in decreasing the rate of aspiration pneumonia in patients with dysphagia. Theoretical Framework Implications Dysphagia patients will benefit from this study by reducing the occurrence of aspiration pneumonia and indirectly improve compliance for hydration, nutritional intake, and medication adherence. References Logemann, J.A., Gensler, G., Robbins, J., Lindblad, A.S., Hind, J.A., Kosek, S., … Gardner, P.J. M. (2008). A randomized study of three interventions for aspiration of thin liquids in patients with Dementia or Parkinson’s disease. Journal of Speech, Language, and Hearing Research, 51, 173-183. doi: 10.1044/1092-4388. Robbins, J., Gensler, G., Hind, J., Logemann, J.A., Lindblad, A.S., Brandt, D., … Gardner, P.J.M. (2008). Comparison of 2 interventions for liquid aspiration on pneumonia incidence. Annals of Internal Medicine, 148, 509-518. Vitalstim (2011). What is Dysphagia? Retrieved from www.vitalstim.com/what_is_dysphagia/index.aspx?id=114