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Dental Hygiene Intervention to Prevent Nosocomial Pneumonias
Institution:1. Division of Dental Public Health and Pediatric Dentistry, Ostrow School of Dentistry of USC, Los Angeles, CA 90089-0641, USA;2. National Center for Dental Hygiene Research & Practice, Ostrow School of Dentistry of USC, Los Angeles, CA 90089-0641, USA;1. Department of Oral Biology, School of Dental Medicine, University at Buffalo - The State University of New York, Foster Hall, Buffalo, NY 14214, USA;2. Geriatrics and Extended Care Services (10P4G), US Department of Veterans Affairs, PO Box 134002, Ann Arbor, MI 48113-4002, USA;1. University of Louisville School of Medicine, Division of Infectious Diseases, Louisville, KY, United States;2. University of Louisville Clinical and Translational Research Support Unit, Louisville, KY, United States;3. Johns Hopkins Bloomberg School of Public Health, Department of Molecular Microbiology and Immunology, Baltimore, MD, United States;4. University of Louisville School of Medicine, Department of Microbiology and Immunology, Louisville, KY, United States;5. Department of Health Science, University of Milan Bicocca, Clinica Pneumologica, AO San Gerardo, Via Pergolesi 33, Monza, Italy;6. Dipartimento di Fisiopatologia e dei Trapianti, University of Milan, IRCCS Fondazione Ca’ Granda Ospedale Maggiore Policlinico, Via F. Sforza 35, Milan, Italy;7. Pulmonary Training Program, San Juan City Hospital, Puerto Rico;8. Department of Infectious Diseases, Hospital Profesor Bernardo Houssay, Vicente López, Buenos Aires, Argentina
Abstract:Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists.BackgroundNosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings.MethodsA comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested.ConclusionDental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias.
Keywords:Dental hygiene  prevention  nosocomial infections  nursing home  critically ill aspiration pneumonia  ventilator associated pneumonia barriers to oral care
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