Pneumonia is the one of the most common healthcare-associated infection in the United States. According to the Centers for Disease Control and Prevention (CDC), non-ventilator healthcare associated pneumonia (NV-HAP) is estimated to make up 65% of all healthcare-associated pneumonia cases.
Modifiable risk factors identified in some studies include oral care, patient mobility, and angle of the head of the bed. Examples of non-modifiable risk factors include age (either very young or very old), immunocompromised status, and presence of chronic respiratory disease or other chronic conditions.
Maintaining good oral hygiene is crucial for overall health and can help reduce the risk of pneumonia and other respiratory infections. Oral care is a modifiable risk factor that applies to virtually all patients. Dental plaque begins to form in the mouth within hours after toothbrushing and will continue to grow rapidly if not removed (e.g. with toothbrushing). Plaque can contain pathogenic bacteria, and NV-HAP can result if these microbes are aspirated into the lungs and the host defense mechanisms fail to eliminate aspirated bacteria.
Routine oral health care can often get overlooked and patients may not receive oral hygiene supplies during hospital and nursing home stays. Oral care in hospitalized patients and nursing home residents is a low risk, low-cost invention, which potentially reduces NV-HAP and leads to the additional benefits of improved oral health.
What can you do to improve oral care for your patients?
- Engage leadership
- Train staff
- Conduct oral health assessments on patients/residents
- Develop written protocols, plans and policies for oral care
- Provide oral health education to the patient/resident
Special considerations must be made for those that cannot open their mouth, have a difficult time holding their head still or up off their chest or if the individuals refuses oral care or forgets to perform oral hygiene care.
- Assist the person in bringing the toothbrush to their own mouth and brush teeth together
- Use different dental products such as adaptive equipment
- Try providing oral care at another time of day when the person is more cooperative or in a different environment that is more suitable
- Ensure that oral care reminders are listed in the care plan
- Enlist the assistance of another caregiver
Additional Resources:
CDC – Oral Health in Healthcare Settings to Prevent Pneumonia Toolkit
CMS – Head to Toe (H2T) Infection Prevention Toolkit
Listen To Our Podcast: Q-Tips For Your Ears!
Understanding Pneumonia: Pneumonia is an infection that inflames the air sacs in one of both lungs and can cause coughing, fever, chills and difficulty breathing. Join the conversation to better understand the causes and risk factors of pneumonia and how you can treat it.
Oral Health- A Window to Your Overall Health: Did you know the health of your mouth, teeth and gums has an impact on your overall health? Take a few minutes to listen and learn more.
Focus 4 Health Series | Up Your Protection From Infections
Week One: Sepsis I Recording
Week Two: Pneumonia and Oral Care I Recording
Week Three: UTI’s I Recording
Week Four: Wound Infections I Recording