Addressing HAP and VAP Risk Factors

Maintaining oral hygiene has been proven to help reduce healthcare-acquired pneumonias (HAPs), including ventilator-associated pneumonia (VAP) and aspiration pneumonia.1,2,3 VAP is the most frequent infection occurring in patients after admission to the intensive care unit (ICU).4

In a large European observational study, almost 25% of patients developed an ICU-acquired infection, and the respiratory site accounted for 80% of these infections. VAP can be associated with increased duration of ventilation, ICU and hospital length of stay, and significantly increased costs.5 Prevention of VAP is possibly one of the most cost-effective interventions currently attainable in the ICU.6

The information in this section, which includes clinical evidence and education, will help you build and implement a comprehensive and evidence-based oral hygiene program for your facility.

REFERENCES: 1. Schleder B, Stott K, Lloyd RC, J Advocate Health Care, 2002;4(1):27-30. 2. Vollman K, Garcia R, Miller L, AACN News. Aug 2005;22(8):12-6. 3. Yoneyama T, et al., J Am Geriatrics Society. 2002;50(3):434-8. 4. Vincent J-L et al. Sepsis in European intensive care units: Results of the SOAP study. Critical Care Medicine 2006, 34:344-353 5. Safdar N et al. Clinical and economic consequences of ventilator-associated pneumonia: a systematic review. Critical Care Medicine 2005, 33:2184-93 6. Shorr AF & Wunderink RG. Dollars and sense in the intensive care unit: the costs of ventilator associated pneumonia. Critical Care Medicine 2003, 31:1582-3.

Reducing Ventilator-Associated Pneumonia Through Advanced Oral-Dental Care: A 48-Month Study
Garcia R, Jendresky L, Colbert L, Bailey A, Zaman M, Majumder M
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The effect of a comprehensive oral care protocol on patients at risk for ventilator-associated pneumonia
Schleder B, Stott K, Lloyd RC
Journal of Advocate Health Care, Spr/Sum 2002;4(1):27-30.
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Basic Nursing Care to Prevent Nonventilator Hospital-Acquired Pneumonia
Quinn B
Journal of Nursing Scholarship, 2013; 00:00, 1-9.
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Introducing an Oral Care Assessment Tool With Advanced Cleaning Products into a High-Risk Clinical Setting
Madeo M, Williams N, Girdham J
Infection Prevention Society Annual Conference; 18-20 September, 2017
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Improved Patient Outcomes and Substantial Economic Savings From Quality Improvement Initiative for VAP Prevention
Hample C
HealthTrust University Conference, August 17-19, 2009
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The Development and Implementation of an Oral Hygiene Policy to an Acute Neurological Rehabilitation Unit
Bell F, Elder R
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Has the Oral Care for Mechanically Ventilated Patients Improved on ITU?
Crowley M, Brown S, Wakefield P
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Ventilator Associated Pneumonia (VAP) — Improving Practice With An Audited Oral Care Intervention
Gray K, Jarvis S, Bomford J, Hayden P, Divekar N
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