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Comprehensive Oral Care

PROBLEM: DENTAL PLAQUE

A biofilm that causes VAP infection.


The oral cavity is a proven source of Hospital-Acquired Pneumonia (HAP), including Ventilator-Associated Pneumonia (VAP)1,2. These pathogens can be aspirated into the lungs and cause infection4. Non-vent patients with dysphagia, stroke, COPD and malignancy are also at risk for HAP5,6


Three Risk Factors for VAP2

• Colonisation of dental plaque
• Bacterial colonisation of the oropharyngeal area
• Aspiration of subglottic secretions*
* Routine suctioning minimises oral secretions which can migrate to the subglottic area.

Incidence and Mortality Rates of VAP

• Mortality rates can reach as high as 76%. (Chastre)7
• VAP is the most common infectious complication among ICU patients, accounting for up to 47% of all infections. (Cason)8

Costs of VAP

• Costs can exceed £25,000/ €28,000 per instance of VAP. (Rello)9



SOLUTION: BEATING BIOFILM WITH COMPREHENSIVE ORAL CARE

Brushing and suctioning address biofilm (plaque).


“If oral care is not started upon admission, the mouth could become colonised with harmful bacteria within the first 48 hours. Plaque on the teeth can provide a breeding ground for this growth of bacteria.…The most effective way to remove plaque is to use a brush.” (Campbell)1 Toothette® Oral Care delivers a comprehensive approach to oral hygiene based on cleaning, debriding, suctioning and moisturising the entire oral cavity.

Comprehensive Protocols

The key to a successful oral hygiene program is an evidence based protocol. Staff education and involvement with the protocol drives compliance, which is essential in achieving positive prevention outcomes. Download a customisable Oral Care Protocol at: www.sageproductsglobal.com/en/clinSupport/SampleProtocols.cfm.



National Institute for Health and Clinical Excellence (NICE) Guidelines4

Technical Patient Safety Solutions for Ventilator-Associated Pneumonia in Adults The NICE guidance covers patients who are on a ventilator and states, “make sure an antiseptic is included as part of the mouth care routine for these patients.”

Efficacy of Oral Chlorhexidine in Oral Care (Wise)5

“...studies unfortunately do not address the essential need for mechanical cleaning prior to chlorhexidine use...” “...chlorhexidine is excellent at inhibiting plaque formation in a clean mouth but is of otherwise limited efficacy...”ents.”

RESULTS:

Reduced risk of costly infection.
Patients breathe easier.


Reducing bacterial colonisation in the mouth and on the surface of the teeth of ICU patients decreases the frequency of VAP1,2. Comprehensive oral care can address three VAP risk factors—bacterial colonisation of the oropharyngeal area, aspiration of subglottic secretions, and colonisation of dental plaque with respiratory pathogens3.

Clinical Results

Reducing VAP One U.S. hospital implemented comprehensive oral care and reduced VAP by more than 60%. Their protocol featured Toothette® brand products and called for oral care every 2 to 4 hours3.

Reducing HAP

Reducing VAP In a 2-year Japanese study at 11 nursing homes, pneumonia risk was significantly reduced in patients receiving oral care. In fact, mortality due to pneumonia was about half that of patients not receiving oral care.

Cost Avoidance

In 17 months, one 350-bed U.S. hospital reduced VAP over 75%, avoiding €1.18 million in costs.‡ Along with a ventilator bundle and head-of-bed elevation, they upgraded from swabs only to Q•Care® cleansing and suctioning every 2 to 4 hours5.



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