A University of Massachusetts Amherst nurse innovator and a research partner have received a $750,000 grant from Illinois-based Delta Dental Foundation to test an oral health strategy aimed at preventing non-ventilator hospital-acquired pneumonia (NVHAP) – the most deadly and costly of all the hospital-acquired infections.
Karen Giuliano, associate professor at the Elaine Marieb College of Nursing and the UMass Institute for Applied Life Sciences (IALS), and Dian Baker, professor emeritus at Sacramento State University, will lead a two-year, interdisciplinary trial in partnership with two Illinois hospitals — the University of Illinois School of Nursing and Hospital and Northwest Community Hospital – and the University of Illinois at Chicago College of Dentistry.
Research has shown that in the first 48 hours after patients are hospitalized, germs can move from the mouth into the lungs, causing pneumonia. Giuliano and Baker have spearheaded NVHAP research to investigate risk factors and how to reduce them.
“Oral health is critical to overall health, and oral hygiene protocols are a key factor in reducing NVHAP,” said Lora Vitek, executive director of Delta Dental of Illinois Foundation. “We work to improve the health and well-being of Illinoisans, and this grant will provide data to help Delta Dental of Illinois Foundation and our hospital partners in the state do just that.”
“We expect that there will be a significant reduction in NVHAP incidence in acute care patients who receive a standardized oral care intervention as compared to acute care patients who do not,” adds Giuliano, co-director of the newly created Elaine Marieb Center for Nursing and Engineering Innovation.
In their ongoing research, Giuliano and Baker have found that NVHAP represents 60% of hospital-acquired cases, affecting approximately one in 100 hospitalized patients and carries an associated crude mortality rate of 13-30%. NVHAP also is associated with increased antibiotic usage, high ICU utilization rates, high readmission rates of 20% for survivors and is the most common pathway to sepsis, an often-fatal infection.
While quality improvement initiatives at hospitals over the past decade have focused successfully on reducing cases of ventilator-associated pneumonia (VAP), there are no regulations requiring hospitals to address NVHAP. As a result, patients, especially those who are non-ventilated and critically ill, remain at significant risk.
“Understanding mechanisms that reduce the incidence of NVHAP remains of paramount importance,” Giuliano says. “In the face of COVID, this issue has assumed an even higher level of importance.”