NON-VENTILATOR HOSPITAL-ACQUIRED PNEUMONIA PREVENTION THROUGH ORAL CARE

Non-ventilator hospital-acquired pneumonia (NV-HAP) is a commonly identified classification of hospital-acquired pneumonia associated with high mortality, increased hospital length of stay, hospitalization costs, and readmission rates within 30 days. There is a lack of prevention strategies, surveillance, and reporting standards to track NV-HAP incidents. The literature provided evidence of the effectiveness of oral care in preventing NV-HAP. The purpose of this quality improvement (QI) project was to educate the nursing staff on a standardized, evidence-based oral care protocol to decrease the occurrence of NV-HAP. The project occurred over two months among acute stroke non-ventilated patients in a Neuro Intensive Care Unit. The Iowa model of evidence-based practice guided the planning and implementation of this QI project. The participants were a convenience sample of 46 registered nurses. Nurses’ knowledge pre-and post-implementation of the oral care protocol was assessed. Aggregate data on NV-HAP occurrences were collected post-implementation. Chi-square test results showed an increase in nurses’ knowledge of the NV-HAP diagnosis post-implementation (78.8%) from pre-implementation (60%) of an oral care protocol. There was an increase in nurses’ understanding of the importance of using an oral care protocol to prevent NV-HAP pre-implementation (42.5%) and post-implementation (46.9%). No NV-HAP occurred post-implementation, with two incidents pre-implementation. This QI project showed that using an oral care protocol can decrease the occurrence of NV-HAP. Nurses are empowered to implement routine oral care protocols as a preventive strategy for healthcare-associated infections, leading to improved clinical outcomes and a decrease in the economic burden placed on hospitals.