Title : Oral care saves lives: Impacting oral health to prevent non-ventilator hospital acquired
Abstract:
Non-ventilator hospital acquired pneumonia (NV-HAP) is associated with increased morbidity and mortality, increased length of stay (LOS), increased risk for sepsis, and increased costs. NV-HAP incidence increased over a 3-year period at a Midwestern acute care community hospital resulting in a $13 million expenditure. Patients were found lacking appropriate oral care supplies and a severe knowledge deficit of the importance of oral care among the nursing staff and organizational leaders. The purpose of this evidence-based practice (EBP) project was to improve nursing staff and organizational leadership knowledge on NV-HAP, preventive measures, and implementation of an oral care protocol/guideline to help reduce the incidence of NV-HAPs by 35%.
Practice change included system-wide purchase of oral care kits consisting of an American Dental Association-approved toothbrush, sodium bicarbonate toothpaste, alcohol-free antiseptic oral rinse, and non-petroleum-based moisturizer for all independent patients. Implementation strategies included conducting a NV-HAP knowledge and oral care perception pre-assessment survey, providing NV-HAP education to nursing staff and organizational leaders, providing in-person oral care competency education to all nursing staff, conducting monthly rounding of patient rooms to ensure access to oral care supplies, and performing a NV-HAP knowledge and oral care perception post-assessment survey.
Evaluation: Data regarding adherence to oral care interventions were collected through direct rounding, observing the use of oral care kits in inpatient rooms. The CDC's definition of NVHAP through the use of ICD-10 coding was used to track NV-HAP incidence. From January 2020 to December 2021 a 20% increase in patients having oral care kits in their rooms resulted. NV-HAP ICD 10 rates decreased by 40% over this time period.
