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This post was written by Ellen Ahlersmeyer, DNP, RN, CNRN, administrative director of nursing services, Parkview Hospital Randallia; and Jan Powers, PhD, RN, CCNS, CCRN, NE-BC, EB-C, FCCM, FAAN, director of nursing research and professional practice, Parkview Health.
Many of us can recall throwing a fit over brushing our teeth as children. Oh, how we wanted to do anything other than take time to brush or floss our teeth! Complaints included not liking the taste of the toothpaste, the kind of toothbrush, or insisting that our teeth were fine and did not need it. We simply did not think about why it was important to do oral care well each day.
Why we bother to maintain good oral hygiene
When we dedicate time to care for our teeth, gums and mouth, our whole body reaps the benefits. Science has proven through rigorous research that maintaining good dental health not only protects against gum disease but also helps ward off many other diseases.
The most common form of gum disease is gingivitis (gum inflammation). It begins when bacteria accumulate in the mouth, forming plaque and tartar on teeth, which, if left untreated, can lead to tooth decay. Gingivitis can also lead to red, swollen and bleeding gums. If left unchecked, gingivitis may advance to more serious periodontitis, which can cause bone deterioration and tooth loss, and reduce the ability to speak and chew properly.
Gum bacteria in dental plaque can cause lung infections when inhaled. This can then affect other aspects of one's health, such as increasing the risk of diabetes, cardiovascular disease, stroke and dementia.
Your oral care routine when hospitalized
As nurses, we recognize that it is even more important to have good oral care when you are in the hospital. Even if you feel very sick or lack the energy to perform basic oral care, Parkview Health nurses provide a structured oral care program to help reduce the bacterial load in your mouth.
In hospitalized patients, non-ventilator hospital-acquired pneumonia (NV-HAP) can develop within 48 hours after hospital admission, with the most common cause being microaspiration of bacteria colonizing the oropharynx and upper airways.
In 2025, at Parkview Hospital Randallia, nursing teams noticed an increase in hospital-acquired NV-HAP among patients admitted to acute care medical floors. In response to seeing this increase, Jan Powers, clinical nurse specialist and Kathy Fisher, nursing director, collaborated to create a plan to decrease the number of NV-HAP by implementing targeted, evidence-based interventions.
Jan shared research reports that the use of care kits, accompanied by an oral care protocol, is a successful strategy that could reduce the incidence of NV-HAP. Per the evidence, kits provide caregivers with essential products for care and remove the barrier to gathering the appropriate supplies. In Jan’s role as research director, she had organizational access to vendors who provide care products to our nursing teams. She was familiar with our vendor’s oral care products and found one kit ideal for this project. The kit includes:
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a soft-bristle toothbrush
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an oral rinse bottle
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a tube of mouth moisturizer
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a tube of sodium bicarbonate (baking soda) mouth paste tube
Jan advised that a good plan for implementing this kit would include removing any care barriers, educating staff and patients, and providing supplies to improve oral care compliance. She suggested to Kathy’s teams that they should review the kit for possible implementation. The kit would give the nursing staff and patient care technicians the appropriate oral care components. The staff was educated about the kit and how its use would improve patient outcomes and support infection prevention efforts. Patient education was also posted in bathrooms to remind patients of the importance of oral care.
The units’ supply rooms were stocked with the oral care kits in April 2025. In May 2025, the nursing manager, assistant managers and clinical nurse specialist began conducting daily reviews of charting and nursing safety quality dashboards to ensure that oral care was completed. Compliance data was shared with team members through daily huddles and just-in-time feedback. To ensure ongoing compliance with the program, the nursing teams’ leaders continue to review NV-HAP rates, oral care completion and kit use periodically.
Outcome
By equipping nursing staff and patient care technicians with appropriate resources and targeted education, there was a significant reduction in NV-HAP.
Unfortunately, although NV-HAP is a known hospital-acquired complication, there is no national database that tracks or compares NV-HAP data. Parkview Health tracks NV-HAP incidence using coded data and converts it to a rate per 1,000 patient days.
To learn more about nursing research activities and how they positively impact patients at Parkview, click here.
