Reducing Hospital-Acquired Pneumonia Through Improved Oral Care
- jenniferpettitcrdh
- Aug 5
- 2 min read
Pneumonia is the most prevalent healthcare‑associated infection (HAI) in U.S. hospitals, with non‑ventilator‑associated healthcare‑acquired pneumonia (NV‑HAP) comprising approximately 65 % of all hospital‑acquired pneumonia cases (CDC, 2024a). Roughly 1.6 % of hospitalized patients develop NV‑HAP, and mortality among these patients ranges from 15 % to 30 % (CDC, 2024a). These figures underscore NV‑HAP as a critical target for prevention efforts.
Importantly, oral care is a key modifiable risk factor. Dental plaque can form within hours without toothbrushing, and contains pathogenic bacteria that, when aspirated into the lungs, can lead to pneumonia if host defenses fail (CDC, 2024a). Consequently, comprehensive oral hygiene protocols are associated with significant reductions in pneumonia incidence.
Several successful quality‑improvement initiatives illustrate the toolkit’s impact. In one Veterans Affairs HAPPEN pilot, standardized oral care reduced NV‑HAP rates by 40–60 % and saved over $100,000 in direct healthcare costs per case prevented (CDC, 2024a). Another project at the Salem, VA VA Medical Center reported a 92 % reduction in NV‑HAP over 19 months, saving 13 lives and approximately $2.84 million (CDC, 2024a). Orlando Regional Medical Center in Florida saw reductions of 85 % in its medical unit and 56 % in its surgical unit over 12 months (2018–2019) after adopting enhanced oral care protocols (CDC, 2024a).
The CDC toolkit outlines implementation guidance, emphasizing leadership support and multidisciplinary prevention teams involving nursing, dental, infection prevention, respiratory therapy, rehabilitation, pharmacy, and quality improvement staff (CDC, 2024a). Key operational steps include staff education on NV‑HAP prevention and oral care, oral health assessments at admission using validated tools (e.g., BOHSE or OHAT), standardized care protocols, and documentation via electronic health record prompts (CDC, 2024a).
Oral care should generally be provided at least twice daily, with supplies including a soft‑bristle toothbrush, fluoride toothpaste (or non‑foaming toothpaste for at‑risk patients), and alcohol‑free antiseptic mouthwash (CDC, 2024a). Documentation should include type and frequency of care, modifications for individual needs or behavioral challenges, and should be audited for adherence.
Routine monitoring and evaluation, combined with sharing of best practices, help sustain quality improvement. Leadership endorsement is essential to secure resources and staff engagement (CDC, 2024a).
In adopting oral care as a low‑cost, low‑risk intervention, hospitals can address a preventable cause of pneumonia, reduce mortality, and realize substantial cost savings. The CDC toolkit offers structured tools for risk assessment, training, protocol development, and evaluation, making it a practical resource for hospitals striving to reduce NV‑HAP (CDC, 2024a).
References
CDC. (2024a). Oral health in healthcare settings to prevent pneumonia toolkit. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from
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