Implementing Oral Care as a Nursing Intervention to Reduce Hospital-Acquired Pneumonia Across the United States Department of Veterans Affairs Healthcare System.

Hospital-acquired pneumonia is a preventable complication. The primary source of pneumonia among hospitalized and long-term care residents is aspiration of bacteria present in the oral biofilm. Reducing the bacterial burden in the mouth through consistent oral care is associated with a reduction in the incidence of hospital-acquired pneumonia. Following a significant reduction in pneumonia among non-ventilated patients in the research pilots, the Veterans Health Administration deployed the evidence-based, nurse-led oral care intervention called Hospital Acquired Pneumonia Prevention by Engaging Nurses as quality improvement nationwide. In this article, nursing informatics experts on the team describe the design and implementation of process and outcome measures of Hospital-Acquired Pneumonia Prevention by Engaging Nurses and outline lessons learned. The team used standardized terms and observations embedded within the EHR documentation templates to measure the oral care intervention in acute care areas. They also developed a tracking system for hospital-acquired pneumonia cases among non-ventilated patients. In addition to improving patient safety and care quality, Hospital-Acquired Pneumonia Prevention by Engaging Nurses links evidence-based practice with nursing informatics principles to generate numerous opportunities to measure the value of nursing at the point of care. This initiative was reported using SQUIRE 2.0: Standards for QUality Improvement Reporting Excellence.