Reduction in aspiration pneumonia at a secondary hospital site by implementing an oral care package.
Emma White1, Matt Brennan 2, Pauline Holgate3, Lisa Majteles11Speech Pathology, Fiona Stanley Fremantle Hospital Group, Perth, WA, Australia2HACs Reduction, Fiona Stanley Fremantle Hospital Group, Perth, WA, Australia3Capacity and Access Service, Fiona Stanley Fremantle Hospital Group, Perth, WA, Australia
Abstract
Background: Patients who acquire pneumonia in hospital have worse outcomes than those without, including increased length of stay and higher mortality. Oral hygiene is a modifiable risk factor for aspiration pneumonia. There are significant barriers to performing oral hygiene in the acute setting.
Aim: To reduce the prevalence of aspiration pneumonia by implementing a best practice sitewide oral care policy.
Method: This quality improvement project was conducted at a secondary hospital in Western Australia between January 2022 and March 2022. A sitewide oral care program was developed and piloted across three wards in 2020 establishing effectiveness in reducing aspiration pneumonia. Adherence to the subsequent policy developed in 2021, was assessed in a point of prevalence audit across six wards. Only one ward met the recommended target of two episodes of oral care per day. This prompted the implementation of a rapid improvement cycle with a multidisciplinary team (MDT) approach to drive change in clinical practice.
Results: An oral care professional development package was deployed across six wards. Average oral care episodes increased from an average of 0.67-1.67 to 2.0 episodes per day across the audit period. Episodes of aspiration pneumonia decreased from 33 to 13 accounting for a saving of $371,436.
Conclusion: Achieving the benchmark of two episodes of oral care per day through the implementation of a rapid improvement cycle/MDT approach coupled with an education package reduced aspiration pneumonia at this hospital site. Reduction in aspiration pneumonia has been clinically proven to have a positive impact on patients’ lives.
Biography
Emma is a senior speech pathologist working at Fremantle Hospital in WA. She specialises in dysphagia in the medical and geriatric population.