Four years ago, when Karen Juliano went to Boston Hospital for hip replacement surgery, she was given a red-pink toilet kit for patients at several hospitals. It contained tissues, bar soap, deodorant, toothpaste and, undoubtedly, unprecedented toothbrushes.

“I can’t believe it. I found a toothbrush without a brush. ” “It didn’t go through a Bristol machine. It was just a stick.”

For most patients, a useless hospital toothbrush will be a minor problem. But it also reminds us of Juliano, a professor of nursing at the University of Massachusetts at Amachus University, in the “blind spot” in American hospitals.

Hospital patients’ failure to brush their teeth or brush their teeth is believed to be a major cause of hundreds of thousands of cases of pneumonia each year. Pneumonia is one of the most common infections in health facilities, and most cases are caused by NVHAP, a non-ventilated hospital that kills up to 30% of infected people, says Juliano and other experts.

But unlike many Infections in hospitalsThe federal government does not require hospitals to report NVHAP cases. As a result, few hospitals understand the origin of the disease, monitor its occurrence, or actively work to prevent it, experts say.

Research papers reviewed by friends show that many NVHAP cases can be avoided if hospital staff carefully brush their bedside patients’ teeth. Instead, many hospitals often skip brushing to give priority to other jobs and offer cheap, ineffective toothbrushes, often unaware of the results, who have been studying NVHAP for more than a decade.

Nursing Assistant Theresa Quills brushes veteran James Massie's teeth in June at the Salem Veterinary Clinic in Salem Veterinary Clinic.  Salem VA re-introduced oral care to prevent pneumonia at a non-ventilated hospital in 2016 and the program has since expanded into Veteran Health Management and is a model for all hospitals.
Nursing Assistant Theresa Quills brushes veteran James Massie’s teeth in June at the Salem Veterinary Clinic in Salem Veterinary Clinic. Salem VA re-introduced oral care to prevent pneumonia at a non-ventilated hospital in 2016 and the program has since expanded into Veteran Health Management and is a model for all hospitals. Rosaire Bushey / Veterans Affairs Department

“I can tell you that most of the tens of thousands of nurses in hospitals today have no idea that pneumonia is caused by germs in the mouth,” Baker said.

Pneumonia Occurs when germs trigger an infection in the lungs. Although NVHAP is responsible for most cases, it has not historically received the same attention as pneumonia associated with pneumonia, making it easier to identify and study in a narrow patient ward.

NVHAP, a risk factor for all hospital patients, is usually caused by bacteria that come out of the mouth and are bacteria that accumulate in the dirty biofilm on unwashed teeth and enter the lungs. Patients are at greater risk if they stay asleep for a long time or do not move, so NVHAP can be prevented by raising their head and getting out of bed more often.

A.D. According to the National Agency for the Prevention of NV-HAP in 2020, this pneumonia affects 1 in 100 hospital patients and kills 15% to 30%. For survivors, the illness usually prolongs their stay in the hospital for up to 15 days and allows them to be treated again or transferred to the intensive care unit within a month.

John McLeler, 83, of Bangalore Maine In 2008, the cause of NVHAP fell after his ankle was broken and he spent 12 days in hospital, said his daughter, Kathy Day. Patient Safety Action Network.

But McLarry’s recovery from the breakup was not due to pneumonia. Two days after he returned home, he was rushed to hospital with a lung infection, where he was admitted to Cessis and spent weeks in a nursing home before being discharged.

He died weeks later, weakened, often deaf, unable to eat, and often said, “It’s too weak to get water out of the straw.” After he gets pneumonia, he doesn’t walk again.

“A week before his fall, he was visiting me and he had a terrible attack on his body,” says Day. “And everything was removable.”

Experts describe NVHAP as a neglected concern, but that seems to be changing.

Last year, a team of researchers – including the Centers for Disease Control and Prevention, the Patriotic Health Administration and the Joint Commission – including Juliano and BakerTo practicalityPromising research paper to begin “National Health Dialogue on NVHAP Prevention”.

The Joint Commission, a non-profit organization that can operate or break hospitals, is considering expanding infection control measures to include more diseases, including NVHAP, said Sylvia García-Hochuchin, director of infection prevention and control.

Separately, ECRI, a non-profit healthcare non-profit organization, identified NVHAP as one of this year’s patient safety concerns.

ECRI Infection Specialist James Davis said the spread of NVHAP was already alarming, but it was “unpredictable” and probably exacerbated by patients’ swelling during hospitalizations.

“We only know what is being reported,” Davis said. “Could this be the tip of the iceberg? I might say in my opinion.”

To better assess the situation, some researchers will ask NVHAP to provide a standard definition of monitoring, which will open the door for the federal government to report or encourage prevention over time. With increasing urgency, researchers are pressuring hospitals not to wait for the federal government to take action against NVHAP.

Baker says she has talked to hundreds of hospitals on how to prevent NVHAP, but thousands more have not yet taken action.

“Big, $ 300,000,” said Baker. “The two most important pieces of evidence to prevent this injury are the things that need to happen in routine care – brushing teeth and getting patients to move.”

That evidence comes from a number of studies showing that those two mechanisms significantly reduce the rate of infection.

In California, A Study at 21 Kaiser Permanente Hospitals To reduce the incidence of hospital-acquired pneumonia by 70%, it was used to re-order oral care and get patients out of bed. as if Sutter Medical Center in SacramentoBetter oral care NVHAP cases are reduced by an average of 35 percent per year.

At the Orlando Regional Medical Center in Florida, an improved oral care unit and operating room for patients. It reduced NVHAP rates by 85% and 56%, respectively, Respectively, compared to the same classes that received regular care. A similar study is being conducted at two hospitals in Illinois.

And the most exciting result came from the Patriotic Hospital in Salem, Virginia. In 2016, the oral care pilot program reduced the NVHAP rate by 92 percent – saving an estimated 13 people in 19 months. The program, HAPPEN InitiationIt is rolled out in Veterans Health Management, and experts say it could serve as a model for all American hospitals.

Nurse Officer Michel Lukatoto, who runs HAPPEN, trains nurses to effectively brush their patients’ teeth and teaches patients and their families the relationship between oral care and NVHAP prevention. Although brushing teeth does not seem to require training, Lucatoto Coronavirus illustrates how many Americans wash their hands in a more unprofessional manner.

“Sometimes we are looking for the most complicated intervention,” she said. “We always need that new surgery or some new technical equipment. And I think we sometimes fail to see the simple things we can do to save lives.

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