Background: Patients who acquire pneumonia in hospital have worse outcomes than those without, including increased length of stay and higher mortality. Aspiration pneumonia is a bacterial infection of the lungs caused by aspiration of organisms from the oropharynx and a condition which speech pathology practice seeks to reduce the incidence of. Oral hygiene is a modifiable risk factor for aspiration pneumonia. There are significant barriers to performing oral hygiene in the acute care setting.

Objectives: To reduce the prevalence of aspiration pneumonia by implementing a best practice, sitewide oral care policy.

Method: This quality improvement project was conducted at a secondary hospital in Western Australia between January 2022 and March 2022. A sitewide oral care program was developed and piloted across three wards in 2020 by a multidisciplinary team (MDT) involving speech pathology, nursing and Hospital Acquired Complications (HACs) reduction team, establishing effectiveness in reducing aspiration pneumonia. Adherence to the subsequent policy developed in 2021, was assessed in a point of prevalence audit across six wards. Only one ward met the recommended target of two episodes of oral care per day. This prompted the implementation of a rapid improvement cycle with a MDT approach to drive change in clinical practice.

Results: An oral care professional development package was deployed across six wards. Average oral care episodes increased from an average of 0.67-1.67 to 2.0 episodes per day across the audit period. Episodes of aspiration pneumonia decreased from 33 to 13 accounting for a saving of $371,436.

Conclusion: Achieving the benchmark of two episodes of oral care per day through the implementation of a rapid improvement cycle/MDT approach coupled with an education package reduced aspiration pneumonia at this hospital site. Reduction in aspiration pneumonia has been clinically proven to have a positive impact on patients’ lives.

1. The importance of the MDT, particularly nurses, they are the primary point of care and advocacy for the patient and they are pivotal in the provision of oral care.
2. Regular auditing and feedback, really showed changes over time and allowed the opportunity to provide ad hoc training and mentoring of staff.
3. The importance of marketing policy and any quality improvement projects. This includes at the local ward level and larger organisation level.