Oral Care for Non-Ventilator Associated Hospital-Acquired Pneumonia Prophylaxis: Optimizing Clinical Outcomes and Organizational Effectiveness

Authors

  • Olivia Lounsbury Patient Safety Movement Foundation
  • Shannon Munro, PhD, APRN U.S. Department of Veterans Affairs

DOI:

https://doi.org/10.33940/U.S.%20Department%20of%20Veterans%20Affairs

Abstract

Non-ventilator-associated hospital-acquired pneumonia (NV-HAP) is a largely preventable illness. Quality improvement efforts including prevention measures, such as oral care, are incorporated into most standard clinical workflows but may be performed in an inconsistent manner. Oral care can have a profound impact on rates of pneumonia when performed in a systematic manner for all hospitalized patients, regardless of “traditional” risk factors. Furthermore, oral care can be performed by patients themselves in many cases, thereby relieving frontline staff of this task. Introducing patient education for sustained oral care efforts postdischarge and encouraging healthy habits to aid in achievement of their recovery goals is essential. The prevention of even 100 cases of NV-HAP is associated with a cost savings of $400 million and a decrease of 700–900 hospital days.

Author Biographies

Olivia Lounsbury, Patient Safety Movement Foundation

Olivia Lounsbury (olivia.lounsbury@patientsafetymovement.org) is a clinical research coordinator for the Patient Safety Movement Foundation.

Shannon Munro, PhD, APRN, U.S. Department of Veterans Affairs

Dr. Shannon Munro is an advanced practice nurse and the national implementation lead for HAPPEN (Hospital-Acquired Pneumonia Prevention by Engaging Nurses) for the U.S. Department of Veterans Affairs Diffusion of Excellence Initiative.

References

Quinn B, Baker D, Munro-Cohen S, Stewart J, Lima C, Parise C. Basic Nursing Care to Prevent Nonventilator Hospital-Acquired Pneumonia. J Nurs Scholarsh. 2014;46(1), 11-19. doi: 10.1111/jnu.12050.

Magill SS, O’Leary E, Janelle SJ, et al. Changes in Prevalence of Health Care Associated Infections in U.S. Hospitals. N Engl J Med 2018: 379(18), 1732-1744. doi: 10.1056/NEJMoa1801550.

Fields LB. Oral Care Intervention to Reduce Incidence of Ventilator-Associated Pneumonia in the Neurologic Intensive Care Unit. J Neurosci Nurs 2008;40(5):291-298. doi:10.1097/01376517-200810000-00007

Giuliano K, Baker D, Quinn B. The Epidemiology of Nonventilator Hospital-Acquired Pneumonia in the United States. Am J Infect Control. 2018;46(3). doi: https://doi.org/10.1016/j.ajic.2017.09.005

Turner M, Ship J. Dry Mouth and Its Effects on the Oral Health of Elderly People. J Am Dent Assoc. 2007;138 suppl 15S-20S. doi: 10.14219/jada.archive.2007.0358

Chebib N, Cuvelier A, Malezieux-Picard A, Parent T, Roux X, Fassier T, Muller F, Prendki V. Pneumonia Prevention in the Elderly Patients: The Other Sides. Aging Clin Exp Res. 2019. https://doi.org/10.1007/s40520-019-01437-7

Stolbrink A, McGowan L, Sama H, Reilly H, Jones S, Turner A. The Early Mobility Bundle: A Simple Enhancement of Therapy Which May Reduce Incidence of Hospital-Acquired Pneumonia and Length of Hospital Stay. J Hosp Infect. 2014;88(1). doi: https://doi.org/10.1016/j.jhin.2014.05.006.

Baker D, Quinn B. Hospital Acquired Pneumonia Prevention Initiative-2: Incidence of Nonventilator Hospital-Acquired Pneumonia in the United States. Am J Infect Control. 2018;46(1). doi: 10.1016/j.ajic.2017.08.036.

Munro S, Baker D. (2019). Integrating Oral Healthcare Into Patient Management to Prevent Hospital-Acquired Pneumonia- A Team Approach. J Mich Dent Assoc. 48-57. https://www.michigandental.org/Portals/pro/Journals/July%202019/html5/index.html?page=1&noflash

Munro S, Baker D. (2018). Reducing Missed Oral Care Opportunities to Prevent Non-Ventilator Associated Hospital Acquired Pneumonia at the Department of Veterans Affairs. Appl Nurs Res. 44, 48-53. Doi: 10.1016/j.apnr.2018.09.004. https://pubmed.ncbi.nlm.nih.gov/30389059/

Munro S, Haile-Mariam A, Greenwell C, Demirci S, Farooqi O, Vasudeva S. (2018). Implementation and Dissemination of a Department of Veterans Affairs Oral Care Initiative to Prevent Hospital Acquired Pneumonia Among Non-Ventilated Patients. Nurs Adm Q. 42(4), 363-372. doi: 10.1097/NAQ.0000000000000308. https://pubmed.ncbi.nlm.nih.gov/30180083/

half of cartoon man's head with mouth open and little germs with boxing gloves on

Published

2020-12-17

How to Cite

Lounsbury, O., & Munro, S. (2020). Oral Care for Non-Ventilator Associated Hospital-Acquired Pneumonia Prophylaxis: Optimizing Clinical Outcomes and Organizational Effectiveness. Patient Safety, 2(4), 78–81. https://doi.org/10.33940/U.S. Department of Veterans Affairs

Issue

Section

Patient Safety Initiatives
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