Although they are much maligned by those who don’t live in fear of tooth decay, dentists could play a much bigger role in healthcare. As providers work to reduce hospital-acquired pneumonia, a study has called attention to the role dentists could play.
Teeth are the only nonshedding surfaces of the body and acquire loads of bacteria, according to an article by the ECRI Institute for the Pennsylvania Patient Safety Authority. In cases where hospitals used “mechanical or topical chemical disinfection (or both), or topical antibiotic” there was a 40 percent decrease in hospital-acquired pneumonia, or HAP. Mind you, oral hygiene is not a be-all and end-all of risk factors, but it’s certainly a significant one. As the report points out:
“The dental professional may be a missing link in the chain of HAP prevention.”Advertisement
The report spotlighted the ongoing concern that even as hospitals have worked effectively to reduce ventilator-associated pneumonia, the number of cases of nonventilator hospital-acquired pneumonia continues to be an even greater problem. Patients at risk for ventilator-associated pneumonia are easier to detect, the report notes, because they require an endotracheal tube or tracheostomy, require life support and are commonly admitted to specific areas of the hospital.
Hospital-acquired pneumonia accounts for about 15 percent of hospital-acquired infections, according to data from the Centers for Disease Control and Prevention cited by the report. Pneumonia is one of three areas that healthcare providers need to improve readmission rates according to provisions in the Affordable Care Act. If they do not succeed in reducing readmission rates to ensure they are in line with the national average, they face reductions in Medicare reimbursements.
Focusing on data derived from Pennsylvania hospitals, the report notes from 2009 to 2011, cases of pneumonia associated with ventilators fell by nearly one-third to 640. But there were a greater number cases of nonventilator hospital-acquired pneumonia that decreased at a lower rate from 1,976 to 1,773 in the same time span. There were 317 deaths from nonventilator hospital-acquired infections in 2011 compared with 127 deaths from pneumonia associated with ventilators in the same year.
James Davis, senior infection prevention analyst with Pennsylvania Patient Safety Authority, said because patients at risk for NV-HAP are so diverse and spread out geographically, these patients and cases are difficult to detect, according to emailed responses to questions from MedCity News.
Davis added: “Case identification is possible through accurate, timely data collection. Future data mining through using [electronic medical records] may be possible but is in its infancy at present.”
In the past three years, the report notes, the cost of treating patients with nonventilator hospital-acquired pneumonia in Pennsylvania was about $156.8 million compared with $86 million for ventilator-associated pneumonia.