Wednesday, December 25, 2013
Cleaning Up Health
FHA explores ways to avoid getting sick in hospital
Released by Fraser Health
Fraser Health research team has successfully linked enhanced oral care to a reduction in hospital acquired pneumonia in non-ventilated, care-dependent patients through a study at Royal Columbian Hospital.
Hospital acquired pneumonia is a common infection and a significant cause of morbidity and mortality, leading to increased length of stay in hospital, increased costs to the health system, and decreased quality of life. There has been some research that has linked poor oral care with an increased risk of pneumonia, but evidence is limited to certain settings, such as critical care. The goal of the study was to explore how enhanced oral care can reduce hospital acquired pneumonia in neurologically impaired patients who are not ventilated and dependent upon others for their daily care.
The study was conducted on a neurosurgical unit at Royal Columbian Hospital where there was no standard protocol for oral care in place. Therefore, the team established an enhanced oral care protocol and tested it for six months. Prior to the implementation, a series of education sessions were held for nursing staff to become familiar with the purpose of the study, the enhanced oral care protocol, and the study’s nursing documentation tools.
“Staff really responded to this study. While there is a little bit of additional work for staff to do to ensure the oral care protocol is followed, they save time by not having to treat pneumonia, and not having to prepare for tests and x-rays,” said Dulcie Carter, Registered Speech Language Pathologist and research team co-lead, Fraser Health.
The enhanced oral care protocol included a mouth assessment every four hours plus as often as needed, mouth cleansing with suction toothbrush and oral solution every 12 hours including brushing for one to two minutes, mouth cleansing with suction swab and oral solution every four hours plus as often as needed, and moisturizing the mouth and lips with a water-based non-petroleum mouth moisturizer following the cleansing.
The study showed a 75% reduction in hospital acquired pneumonia. This is significant given that in 2012, the rate of pneumonia in this patient population was 26%.
“I believe we’ve saved lives through this work. It’s estimated that over the six months of the study, we prevented about six cases of pneumonia. Each one of those is a person that didn’t get pneumonia and didn’t die because of it. And the legacy of that work is now a regional protocol across Fraser Health that will prevent even more cases of pneumonia,” said Trudy Robertson, Clinical Nurse Specialist and research team co-lead, Fraser Health.
As a result of this research, a regional protocol for enhanced oral care was established and is now in the implementation phase.
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