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Improving Resident Oral Health and Adherence to a Ventilator-Associated Pneumonia Bundle in a Skilled Nursing Facility

Finch Guthrie, Patricia, PhD, RN; Rayborn, Shelley, MSN, RN, PHN; Boatright, John, PhD, RRT; Pearson, Valinda, PhD, RN, CRRN; Wieting, Rosemary, BSN, RN; Peterson, Randy, MSN, RN; Danahy, Molly, BSN, RN

doi: 10.1097/NCQ.0000000000000321

Ventilator-associated pneumonia (VAP) is common with mechanical ventilation. VAP bundles have improved outcomes in acute care and long-term acute care hospitals. This article reports on an implementation of a VAP bundle designed for a skilled nursing facility (SNF). The primary goal was to improve oral health, a significant factor for VAP, and improve SNF nurse adherence to the bundle. Improvements in oral health and adherence were demonstrated. Nurses had difficulty with adhering to maintaining the tracheostomy cuff seal.

Interprofessional Education Department (Dr Guthrie), Department of Nursing (Ms Rayborn and Dr Pearson), and Department of Respiratory Care (Dr Boatright), Henrietta Schmoll School of Health (HSSH), St Catherine University, St Paul, Minnesota; and Benedictine Health Center, Minneapolis, Minnesota (Mss Wieting, Peterson, and Danahy).

Correspondence: Patricia Finch Guthrie, PhD, RN, Interprofessional Education Department, St Catherine University, 2004 Randolph Ave, St Paul, MN 55105 (

The authors acknowledge Dr John Mielke, medical director, and Ryan Ward, respiratory therapist, for their assistance in developing and implementing the HOME bundle.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: November 27, 2017

Published ahead of print: January 5, 2018

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