Reduction of Healthcare-Associated Respiratory Infections Through Qualification of Oral Care: Experience of a Large Hospital in Minas Gerais

Prevention of healthcare-associated respiratory infections (HAIs) represents one of the greatest challenges for hospital institutions, especially in intensive care settings. The hospital infection control service (SCIH) of a large hospital in Minas Gerais correlated HAI data with the institutional profile to develop prevention strategies. It was evidenced that 21% of hospitalized patients were classified as intensive and semi-intensive care patients. This population is highly vulnerable to respiratory infections, whose topography accounts for 33% of infections in the institution. The objective of the project is to strengthen oral hygiene and evaluate its effectiveness in preventing respiratory infections. The project was developed over 6 months in one adult intensive care unit and began with a focus on training the nursing team in HAI prevention and oral health, as well as replacing the traditional work instrument (forceps and gauze) with a disposable oral hygiene swab with dentifrice. A quality audit of patient oral hygiene performance was established through inspections of bundles carried out by unit nurses and the SCIH, in addition to establishing the systematics of recording and checking Oral Hygiene in the care prescription through the SAE. From the implemented strategies, savings of around R94, 000 were evidenced over the semester, with R62, 500. 00 from replacing the traditional instrument and reprocessing costs, in addition to R15, 600 from reusing existing kits to assemble new hospital kits. From the care standpoint, with team training, execution of the oral hygiene technique improved, providing a 40% reduction in respiratory infections. As a result, antibiotic consumption decreased by R16, 000 in the unit. Another important datum was a decrease in the average hospital length of stay from 4. 27 to 4. 05 days and, especially, a 19% reduction in sector mortality. The obtained data reinforce the importance of oral health as an essential role in preventing respiratory infections, associated with process review and strengthening a patient safety culture, promoting higher quality care. In addition, the project contributed to improving hospital performance through cost reduction and bed management.