Oral Care Guideline Improves Consistency of Care while Reducing Non-ventilator Hospital-Acquired Pneumonia

Abstract

Hospital-acquired pneumonia is one of the leading causes of morbidity and mortality from nosocomial infections existing today. Of the two types of hospital-acquired pneumonia, ventilator-associated pneumonia and non-ventilator-associated pneumonia, non-ventilator acquired pneumonia is more prevalent, equivalent in mortality, and resultant of a higher economic burden. Research findings support greater attention and prioritization be given to universal assessment and preventative measures, such as oral care, in addressing this significant safety issue. Nursing research has proven that a standardized oral care guideline improves the frequency and quality of oral care provided. Lack of oral care has been directly related to the presence of non-ventilator hospital-acquired pneumonia cases. Using a convenience sample of 33 nurses at an acute care hospital on the west coast of the United States and a pre- and post-test design, an oral care practice survey was administered to nursing staff as a means of data collection for oral care practices. Frequency of oral assessments, oral care, and cases of non-ventilator hospital-acquired pneumonia pre- and post-implementation was collected from documentation and compared using Wilcoxon-signed-rank tests. The results revealed the implementation of an evidence-based oral care guideline improved the frequency of oral assessments and oral care (p = .001). Pre and post oral care practice survey results were statistically significant and showed marked improvement, and the number of NV-HAP cases were decreased by 15.2%. Based on the findings of this project it is recommended that future projects expand to include oral care as infection prevention measures.

Keywords: non-ventilator hospital-acquired pneumonia, oral care guidelines