Daily Oral Care with Chlorhexidine Urged for Ventilated Patients

Oral care helps critical care patients defend against ventilator-associated pneumonia (VAP), a common, often fatal and very costly hospital-acquired infection. According to research cited by the Institute for Healthcare Improvement (IHI), hospital mortality of ventilated patients who develop VAP is as high as 46 percent and each incident adds an estimated cost of $40,000 to a typical hospital admission. Recently, the IHI added daily oral care with 0.12 percent chlorhexidine (CHG) to its recommended ventilator bundle advising oral care with CHG for hospitals striving to achieve their prevention goals. Since Sage Products' first venture in creating products to improve patient safety, the company continues to help clinicians implement successful oral care programs that deliver positive outcomes and improve a hospital's bottom line.

Mercy Medical Center in Springfield, Mass. implemented its comprehensive oral care protocol in 2005 and in the last three months of its initial six-month trial saw the number of VAP cases immediately decrease to zero. More recently, between November 2008 and March 2010, the hospital has experienced a consecutive 16-month period with zero VAP cases.

"I think intuitively many within the medical community felt that oral care was key in preventing nosocomial pneumonias," says George Karras, MD, medical director of the intensive care unit at Mercy Medical Center. "The IHIs adjustment suggests that oral care with CHG has graduated to become an official intervention."

Preventing VAP in patients has been a targeted IHI intervention since the organization first launched its 100,000 Lives Campaign in 2005. A comprehensive oral care program along with other clinical interventions has proven to reduce and/or eliminate VAP incidence in hospitals across the U.S. Addition of daily oral care addresses dental plaque biofilm, a proven VAP risk factor. CHG antiseptic has long been approved as an inhibitor of dental plaque formation and gingivitis. Dental plaque biofilms are colonized by respiratory pathogens in mechanically ventilated patients.

"Oral care is a simple way to prevent and improve patient outcomes," says Kathleen Hutchins, RN, MSN, clinical nurse specialist at Mercy Medical Center. "Adding daily oral care with CHG to the vent bundle is not only a victory for patients but also for clinicians who've been driving the practice for years."

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