The Effect of Oral Care on Non-Ventilator Associated Hospital Acquired Pneumonia

Oral care is a standard nursing intervention that affects patients in multiple ways, including comfort, oral health, and risk of pneumonia. While standard oral care has been shown to positively affect the rate of ventilator-associated hospital acquired pneumonia (V-HAP), there is less data regarding the effects of a standardized oral care protocol on non-ventilator associated hospital acquired pneumonia (NVHAP). A review of literature shows that although hospitals’ efforts have been focused on reducing V-HAP and other hospital acquired infections, monitoring for and interventions to prevent NVHAP have not been as much of a focus. In 2014, the results of the Hospital Acquired Pneumonia Prevention Initiative (HAPPI) study revealed 61 cases of NVHAP at Baystate Medical Center, with an associated cost to the hospital of almost 2.5 million dollars. Using a gap analysis and educational needs assessment, a standardized oral care protocol will be developed and presented to all nursing staff, including patient care technicians, on South Wing 5. Over the course of a year, I will educate nursing and ancillary staffs on the basics of appropriate oral care in the non-ventilated patient population, and conduct an assessment of NVHAP cases on the unit. The goals of this project include 1) increased compliance with oral care standards, 2) improved documentation, and 3) decreased incidence of NVHAP with a corresponding decrease in cost of care. This research will also add to the database regarding prevention of NVHAP, and show how basic nursing care benefits all patients.