Oral care practices and hospital-acquired pneumonia prevention: A national survey of Australian nurses.

BACKGROUND: Hospital-acquired pneumonia (HAP) also known as non-ventilator associated pneumonia, is one of the most common infections acquired in hospitalised patients. Improving oral hygiene appears to reduce the incidence of HAP. This study aimed to describe current practices, barriers and facilitators, knowledge and educational preferences of registered nurses performing oral health care in the Australian hospital setting, with a focus on the prevention of HAP. We present this as a short research report. METHODS: We undertook a cross sectional online anonymous survey of Australian registered nurses. Participants were recruited via electronic distribution through existing professional networks and social media. The survey used was modified from an existing survey on oral care practice. RESULTS: The survey was completed by 179 participants. Hand hygiene was considered a very important strategy to prevent pneumonia (n = 90, 58%), while 45% (n = 71) felt that oral care was very important. The most highly reported barriers for providing oral care included: an uncooperative patient; inadequate staffing; and a lack of oral hygiene requisite. Patients' reminders, prompts and the provision of toothbrushes were common ways believed to help facilitate improvements in oral care. CONCLUSION: Findings from this survey will be used in conjunction with consumer feedback, to help inform a planned multi-centre randomised trial, the Hospital Acquired Pneumonia PrEveNtion (HAPPEN) study, aimed at reducing the incidence of HAP. Findings may also be useful for informing studies and quality improvement initiatives aimed at improving oral care to reduce the incidence of HAP.

Assessing a temporary isolation room from an infection control perspective: A discussion paper.

INTRODUCTION: Assessing the functionality and infection control implications of new technologies presents significant challenges. In this discussion paper, we present our approach to assessing infection control aspects of a new isolation room, the RediRoom™ (prototype). We report how we evaluated this room, lessons learnt and suggestions for future evaluations in this area. METHODS: There is no documented method for evaluating a novel temporary isolation room. We combined a range of existing tools to undertake a technical assessment. Three approaches were used, an assessment against standards or guidelines; professional assessment; and a cleaning assessment. RESULTS: To assess compliance against existing recommendations related to the built environment and isolation rooms, elements contained within Australasian and United Kingdom guidelines were used. We were able to identify which elements in these guidelines were of the most value and relevance. An ultraviolet (UV) solution with fluorescent light assessment was used to assess the ability to clean surfaces. This approach was a useful objective measure. A professional assessment is potentially subjective, but provides an opportunity to identify other potential issues and benefits. In this study, the RediRoom™ performed well against all three approaches. We identified limitations in using existing guidelines for a temporary isolation room. CONCLUSION: In our study, the use of video and video reflexive ethnography for the professional assessment would have been useful. We propose a revised list of assessment against which new isolation solutions or technologies could be assessed, with the view of others continuing to build on this.