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Can J Neurosci Nurs. 2013;35(2):10-7.

Oral intensity: reducing non-ventilator-associated hospital-acquired pneumonia in care-dependent, neurologically impaired patients.

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  • 1Fraser Health.



The purpose of this point-of-care study was to test the efficacy of a prevention-based oral care protocol in reducing non-ventilator-associated hospital-acquired pneumonia in a neurosurgical population outside the critical care environment. The researchers hypothesized that an enhanced oral care protocol would decrease the incidence of pneumonia.


This quasi-experimental, comparative study took place on an acute neurosurgical unit at a tertiary care trauma hospital in Western Canada. Subjects were non-intubated, care-dependent adults with a primary diagnosis of neurologic injury/insult, and at high risk for pneumonia. The prospective study group comprised 34 subjects; two subjects were excluded from the study analysis. The retrospective study group comprised 51 subjects. Data were collected for both groups for a six-month period. Retrospective data were collected through chart review. The prospective group were eligible neurosurgical patients who received the enhanced oral care protocol. Data collection tools were developed and diagnostic criteria for hospital-acquired pneumonia were determined. The pneumonia rates between subjects who received standard oral care (retrospective group) and those who received an enhanced, prevention-based, oral care protocol (prospective group) were compared.


A statistically significant decrease in the pneumonia rate occurred in the prospective group (p < 0.05).


An enhanced oral care protocol was beneficial in reducing the incidence of non-ventilator-associated hospital-acquired pneumonia.


Nurses play a vital role in preventing hospital-acquired pneumonia. Foundational nursing practices, such as regular oral hygiene, are important aspects of care in preventing nosocomial infections and related costs, optimizing health, and promoting quality care.

[PubMed - indexed for MEDLINE]
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