In the Loop

News and views from across Mayo Clinic

November 15, 2022

Collaboration leads to better oral care, prevents pneumonia for patients in intensive care

By In the Loop

A collaboration between Dental Specialties and Cardiovascular Surgical Intensive Care Unit staff at Mayo Clinic in Rochester led to a pilot project where dental hygienists provide critical care patients with much-needed oral care and help prevent ventilator-assisted pneumonia.

Patients who are hospitalized in an intensive care unit can often be at risk for acquiring ventilator-associated or non-ventilator-acquired pneumonia. Studies have shown that proper oral care can help prevent this from happening.

Mayo Clinic formed a multidisciplinary workgroup to launch an oral care initiative focused on patients who were not ventilated, but learned that oral care compliance could be improved.

A collaboration between Dental Specialties and Cardiovascular Surgical Intensive Care Unit staff at Mayo Clinic in Rochester aimed to change that. The teams launched a pilot project in October where dental hygienists became part of the care team to provide patients with much-needed oral care.

The News Center team caught up with Sarah Hoerler, a dental hygienist from Dental Specialties, to learn more about the pilot project and its success.

What was the problem you were facing with hospital-acquired pneumonia? 

It was not necessarily a problem with hospital-acquired pneumonia, but rather a problem with oral care compliance, which can prevent ventilator and non-ventilator-associated pneumonia. Oral care performed on ventilated patients is the most modifiable intervention that can reduce the incidence of these hospital-acquired infections, with ventilator-associated pneumonia being the most common nosocomial infection in intensive care units. Nursing staff understand the importance of oral care. However, it is a lower priority when caring for critically ill patients, which is reflected in low oral care compliance. 

What did you have to do differently to adapt? 

Caring for patients as a dental hygienist was a unique opportunity to use our education and oral health expertise to collaborate with medical colleagues to provide a value-added service. Providing oral care to patients improves patient outcomes. There is a real need for oral care across the hospital setting, especially for those patients on ventilators.    

How was the project received? 

The dental hygienist pilot was very well received, with medical colleagues being very grateful for our collaboration and several registered nurses stating that the dental hygienist should be an essential member of the intensive care unit team. In addition, patients' families expressed high satisfaction with the oral care the dental hygienists were performing and felt their loved ones were being well taken care of. 

What do you think were the biggest factors in the success that you saw? 

The biggest factor in success was the gratitude our medical colleagues expressed for the dental hygienists being a part of the multidisciplinary team. In ICUs, there are many specialists, from physical therapists, occupational therapists, respiratory therapists, phlebotomists, radiology technicians, speech-language pathologists, registered nurses, physician assistants and critical-care physicians, just to name a few. Dental hygienists need to be considered valuable members of this critical care team. 

Do you see this changing your overall approach going forward? 

We are exploring the possibility of expanding the pilot across more ICUs.


Tags: Cardiovascular surgical intensive care, Dental Specialties, Practice story, Sarah Hoerler

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