Abstract
Background: Nosocomial infections, specifically pneumonia have consequences financially for the hospital as well as physically and emotionally for the patient and their family. Consistent oral care, a fundamental standard of nursing care, and evaluation of ability to swallow are essential to allow patients to progress to wellness during their acute hospital stay after a stroke. Purpose: The purpose of this study was to determine the efficacy of an oral care program for stroke patients. Research Questions: 1. In non-ventilated stroke patients, will an oral care program reduce the length of NPO status? 2. In non-ventilated stroke patients, what is the effect of an oral care program on LOS? Methods: This was a quasi-experimental study using a convenience sample. The impact of oral care for stroke patients on LOS and NPO status was reviewed pre- (n=33) and post- (n=51) implementation of an oral care program. The oral care program included a Hospital-acquired Pneumonia (HAP) Risk Assessment tool and specific interventions based on the score determined by the tool. Assessment included oral, chewing/swallowing , feeding/oral self-care, and conditions that resulted in a “high risk” score. Measures included length of NPO status per 100 patient days, LOS using descriptive statistics, and the difference in means from initial to final score using a Paired Samples t-Test. Results: The length of NPO status per 100 patient days decreased from 23.07 to 3.3 (85.7%). The LOS mean decreased from 9.45 to 6.92 days (26.8%). No HAP cases were present in the pre-or post-intervention groups. The initial HAP Risk Assessment scores improved from a 1.09 mean to 0.73 for the final HAP risk score (t =1.345, p =0.185 [2-tailed], SEM =0.264, n =45). Conclusions: The program showed improvement in NPO status, a decreased LOS and improved HAP risk scores from initial to final. Further testing of the tool and interventions is indicated using a larger sample.
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