Improving Oral Care in the Hospital: Program HOPE

Oral care is a proven intervention for reducing non-ventilator-associated hospital-acquired pneumonia (NV-HAP) rates by 40%-60%. Comprehensive oral care education programs are not widely reported among hospital settings in the United States. We launched the nurse-driven Hospital Oral Care and Periodontal Disease Education (HOPE) program in July 2022 with an aim to establish evidence-based oral care protocols for hospitalized older adults to reduce NV-HAP.

This retrospective observational study evaluated the impact of the HOPE program, a quality improvement initiative, on oral care delivery, documentation rates, and the incidence of NV-HAP among hospitalized older adults over a 60-month period from January 2021 to December 2025.

About 33,155 hospitalized older adults were analyzed. Oral care documentation rates demonstrated significant improvements from pre-implementation to post-implementation across all age groups. The 65-74 age group exhibited improvement in documentation from 30% to 57%. Patients aged 75-84 demonstrated comparable trends, with overall documentation increasing from 31% to 58%. The ≥ 85 age group showed documentation rates increased from 30% to 56%. Both genders had similar trends, with females from 32% to 58% and males from 29% to 57%. The rates of NV-HAP remained similar across the pre-implementation phase (2.1%), Pilot phase (2.3%), and post-implementation phase (2.4%).

HOPE program improved oral care adherence and documentation, particularly for hospitalized older adults. The program's outcomes emphasize the importance of evidence-based standardized protocols, staff education, patient engagement, and a multidisciplinary approach to enhance patient safety across diverse patient populations.