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Introducing an oral care assessment tool with advanced cleaning products into a high-risk clinical setting

12 March 2020
Product Focus
02 March 2020
Volume 29 · Issue 5

Abstract

Poor oral hygiene is an important risk factor for the development of non-ventilator hospital-associated pneumonia (NV-HAP), which imposes a significant burden on the NHS. This study aimed to establish whether the use of a 24-hour oral care kit and an oral care assessment tool can meet the needs of patients on an acute stroke unit. In comparison with the same period the preceding year, the introduction of the oral care kit and assessment tool improved compliance with oral care by more than 4 times; the overall costs of antibiotics to treat NV-HAP patients fell by 79%, with the number of doses falling by 70%, and the mortality rate decreased from 27% to 20%. According to a survey of multidisciplinary team (MDT) members keeping oral care tools available at the point of use saved time, and the oral health of patients on the unit improved after the introduction of the oral care kit and assessment tool. Almost all MDT members would recommend the use of the kit over previous interventions.

Pneumonia is responsible for about 23% of all healthcare-associated infections in the UK (National Institute for Health and Care Excellence (NICE), (2016). Non-ventilator hospital-acquired pneumonia (NV-HAP) is associated with increased patient morbidity, mortality, length of stay and transfer to an intensive care unit (Westendorp et al, 2011; Davis and Finley, 2012; Quinn et al, 2014; Mitchell et al, 2019). Consequently, NV-HAP imposes a significant economic and clinical burden on the NHS. A meta-analysis found that overall 10% of stroke patients develop pneumonia (95% confidence interval [CI] 9-10%), rising to 28% (95% CI 18-38%) in ICUs. Pneumonia was associated with a more than threefold increase in mortality (odds ratio [OR] 3.62; 95% CI 2.80-4.68) (Westendorp et al, 2011). However, despite its clinical and economic importance, the incidence of NV-HAP seems to be under-reported and poorly studied (Mitchell et al, 2019).

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Oral hygiene
Non-ventilator hospital-acquired pneumonia
NV-HAP
Stroke unit
Antibiotics