Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurses

Peta Ellen Tehan; Katrina Browne; Georgia Matterson; Allen C Cheng; Sonja Dawson; Nicholas Graves; Douglas Johnson; Martin Kiernan; Auxillia Madhuvu; Caroline Marshall; Julee McDonagh; Maria Northcote; Jayne O'Connor; Liz Orr; Helen Rawson; Philip Russo; Jenny Sim; Andrew J Stewardson; Janet Wallace; Nicole White; Rhonda Wilson; Brett G Mitchell

doi:10.1016/j.idh.2024.04.006

Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurses

Infect Dis Health. 2024 May 8:S2468-0451(24)00028-2. doi: 10.1016/j.idh.2024.04.006. Online ahead of print.

Authors

Peta Ellen Tehan¹, Katrina Browne², Georgia Matterson², Allen C Cheng³, Sonja Dawson², Nicholas Graves⁴, Douglas Johnson⁵, Martin Kiernan⁶, Auxillia Madhuvu⁷, Caroline Marshall⁵, Julee McDonagh⁸, Maria Northcote⁹, Jayne O'Connor¹⁰, Liz Orr¹¹, Helen Rawson⁷, Philip Russo¹², Jenny Sim¹³, Andrew J Stewardson¹⁴, Janet Wallace¹⁵, Nicole White¹⁶, Rhonda Wilson¹⁷, Brett G Mitchell¹⁸

Affiliations

¹ School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia; School of Nursing and Health, Avondale University, Lake Macquarie, New South Wales, Australia.
² School of Nursing and Health, Avondale University, Lake Macquarie, New South Wales, Australia.
³ School of Clinical Sciences, Monash University, Melbourne, Victoria, Australia; Infectious Diseases, Monash Health, Melbourne, Australia.
⁴ Duke-NUS Medical School, Singapore.
⁵ Infection Prevention and Surveillance Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia; Department of Infectious Diseases, The University of Melbourne, Melbourne, Victoria, Australia.
⁶ School of Nursing and Health, Avondale University, Lake Macquarie, New South Wales, Australia; University of West London, London, UK.
⁷ Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia.
⁸ University of Wollongong, Wollongong, New South Wales, Australia; Centre for Chronic & Complex Care Research (CCCCR), Ward B37, Blacktown Hospital, New South Wales, Australia; Western Sydney Local Health District, New South Wales, Australia.
⁹ Research Services, Avondale University, New South Wales, Australia.
¹⁰ Sydney Adventist Hospital, Wahroonga, New South Wales, Australia.
¹¹ Infection Prevention and Surveillance Service, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.
¹² School of Nursing and Health, Avondale University, Lake Macquarie, New South Wales, Australia; Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia; Cabrini Health, Malvern, Victoria, Australia.
¹³ School of Nursing, Midwifery & Paramedicine, Australian Catholic University, North Sydney, New South Wales, Australia.
¹⁴ Department of Infectious Diseases, Alfred Hospital, Melbourne, Victoria, Australia; Central Clinical School, Monash University, Melbourne, Victoria, Australia.
¹⁵ University of Newcastle, Newcastle, New South Wales, Australia.
¹⁶ Australian Centre for Health Services Innovation, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
¹⁷ RMIT University, Melbourne, Victoria, Australia; Central Coast Local Health District, Gosford Hospital, Gosford, New South Wales, Australia.
¹⁸ School of Nursing and Health, Avondale University, Lake Macquarie, New South Wales, Australia; Nursing and Midwifery, Monash University, Melbourne, Victoria, Australia; Central Coast Local Health District, Gosford Hospital, Gosford, New South Wales, Australia; Hunter Medical Research Institute, Newcastle, New South Wales, Australia. Electronic address: brett.mitchell@avondale.edu.au.

PMID: 38724299
DOI: 10.1016/j.idh.2024.04.006

Abstract

Background: Hospital-acquired pneumonia (HAP) also known as non-ventilator associated pneumonia, is one of the most common infections acquired in hospitalised patients. Improving oral hygiene appears to reduce the incidence of HAP. This study aimed to describe current practices, barriers and facilitators, knowledge and educational preferences of registered nurses performing oral health care in the Australian hospital setting, with a focus on the prevention of HAP. We present this as a short research report.

Methods: We undertook a cross sectional online anonymous survey of Australian registered nurses. Participants were recruited via electronic distribution through existing professional networks and social media. The survey used was modified from an existing survey on oral care practice.

Results: The survey was completed by 179 participants. Hand hygiene was considered a very important strategy to prevent pneumonia (n = 90, 58%), while 45% (n = 71) felt that oral care was very important. The most highly reported barriers for providing oral care included: an uncooperative patient; inadequate staffing; and a lack of oral hygiene requisite. Patients' reminders, prompts and the provision of toothbrushes were common ways believed to help facilitate improvements in oral care.

Conclusion: Findings from this survey will be used in conjunction with consumer feedback, to help inform a planned multi-centre randomised trial, the Hospital Acquired Pneumonia PrEveNtion (HAPPEN) study, aimed at reducing the incidence of HAP. Findings may also be useful for informing studies and quality improvement initiatives aimed at improving oral care to reduce the incidence of HAP.

Keywords: Hospital acquired pneumonia; Nursing; Nursing, practical; Oral hygiene; Pneumonia.