• Success: Since inception in 2021, ReddyPort has serviced over 15,000 patients and over 60,000 oral care procedures without mask removal or risk of compromising lung compliance.

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• How essential is routine Oral Care (Q2/Q4) without mask removal for BIPAP patients? According to the findings from a recent study “After adjusting for other factors, we found that the presence of NPPV was the greatest contributor to developing NV HAP, resulting in a nearly sevenfold greater risk.”*1 The referenced study combined with others indicate that current NV-HAP mitigation efforts (periodic mask removal, high flow brides etc) targeting BiPAP patients are ineffective. With ReddyPort, caregivers now have a tool that can be used by the patient, the patient’s spouse or caregiver to deliver consistent within protocol (Q2/Q4) and compliant (2 minute) oral care without the concerns or risks of mask removal or the need for a high flow bridge.

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• Is NV-HAP an HAI and what is the Hospital’s liability risk? Yes, NV-HAP is classified as an HAI and therefore hospitals and caregivers could face potential liability claims from affected patients.
  Reference: Understanding Hospital-Acquired Pneumonia (HAP) (4grewallaw.com)​

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• ReddyPort Clinical Success Scorecard: Oral care programs have been reported to reduce NV-HAP incidence by 60%. With over 15,000 patients served with the ReddyPort Oral Care System, using the CDC NV-HAP calculator compliant oral care can improve the incidence of NV-HAP by an estimated 180 patients, sepsis cases by 65 patients, and Healthcare related costs by $7.2 million or more. Oral care is widely accepted as the MOST MODIFIABLE risk factor for pneumonia and the ONLY prevention strategy that addresses SOURCE CONTROL!​

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• Why are NV-HAP rates with BiPAP so much higher? “Oral colonization with gram negative pathogens may be a prelude to HAP owing to pulmonary aspiration of the oral flora. The sources are not clear but likely include subgingival dental plaque, periodontal spaces, and the upper gastrointestinal tract. 6 Inhalation of oropharyngeal flora into the respiratory tract can cause an inflammatory response ending in endothelial and epithelial injury to the lung parenchyma and pneumonia. 7 ”

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• 365% higher NV-HAP Rates with BiPAP: The infection rate of NV-HAP is 365% higher in NIV patients compared to hospital patients! “The incidence of pneumonia in all hospitalized patients is low at 0.85%. The incidence is much higher in patients receiving NIV (3.1%).” Source

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• How quickly does the oral cavity colonize with bacteria? Evidence shows “. The bacterial cells colonize on the tooth surface within 4 hours of the pellicle formation. The initial colonizers being the Streptococci (S. viridens, S. mitis, S. oralis).” Ref: Biofilm and Dental Implant: The Microbial Link P.6​​

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• NV-HAP leads to Sepsis: Referenced study demonstrates that sepsis impacts 36% of all NV-HAP patients. “In the 2012 calendar year, 119,075 adults had NV-HAP develop; sepsis developed in 36.3% of these cases.” Ref: Sepsis in the Context of NV-HAP pg 9

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• How are Readmissions impacted by NV-HAP? We know as an industry that NV-HAP increases mortality risks and increases read missions: one in five patients will come back to the hospital within 30 days” REF: “Addressing Non-Ventilated Hospital Acquired Infection Prevention” May 2024. P2 www.PSQH.com

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• Why is Compliant Oral Care Essential? “This nurse-led oral-care initiative has reduced NV-HAP incidence by 60% and saved the hospital more than $2 million over 1 year.” Ref: “Comprehensive Oral Care Helps Prevent NV-HAP” American Nurse Today Vol10 No3 pg 19

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• Oral Care is “Primary Driver #1 for NV-HAP Prevention.” AJIC NV-HAP Prevention Best

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• With ReddyPort, Compliant BiPAP® Oral Care is no longer a challenge: According to APIC, to decolonize the mouth, “Brush/swab with suction for 1-2 min using liquid cleansing/antiseptic solution about every 4 h or 6 times/d.” With ReddyPort, bedside clinicians are able to consistently (Q2/Q4) deliver oral care for a full 1-2 minutes without risking patient’s lung compliance. Shortened duration oral care during mask removal is ineffective in decolonizing the mouth. Ref: AJIC NV HAP Prevention Best Practices Table 1 pg A24

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• Mitigate risk of Hypoxia and lung compliance: With ReddyPort, mask removal to deliver oral care is unnecessary, thus eliminating the situation where “Hypoxemia may occur when a patient is being switched from NIV to another device to perform oral care, posing a significant risk.”  Ref: Oral Care in Critically Ill NIV patients P69

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• Joint Commission: Oral Care is the Standard of Care. Call to Action includes: “Overcome beliefs that NVHAP prevention strategies such as oral hygiene and mobility are optional tasks rather than standard-of-care interventions.” Ref: Quick Safety Preventing non-ventilator hospital acquired pneumonia Issue 61 September 2021

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• APIC: Oral Care is the Standard of Care. “Routine oral care following evidence-based oral care protocol should be a fundamental part of patient care to reduce NV-HAP risk related to oropharyngeal colonization.” Ref: AJIC NV HAP Prevention Best Practices pg. A26

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• Control Healthcare Costs: “Developing NV-HAP was associated with a 20.53 (20.39, 20.67) day longer length of stay, a 2.73 (95% CI: 2.48, 3.0) OR for 30-day mortality, a 2.12 (2, 2.26) OR for 1-year mortality, a 34.18 (27.62, 42.29) OR for inpatient sepsis, a $63,995.33 (63,754.5, 64,236.15) increase in total 1-month costs, and a $100,858.61 (100,250.54, 101,466.67) increase in total mean 12-month costs. Ref: AJIC “Association of NV-HAP and Patient
  Outcomes…” pg 1343

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• EMR Charting of Oral Care SNOMED CT Oral Care Codes are now listed in the International Release (2023) and available for your Hospital’s EMR for efficient documentation of BiPAP® oral care procedures that can be tied to outcomes.

 

470071000124104| Changed to Brushing of teeth declined
470391000124100| Independent brushing of own teeth
472171000124104| Assistance required to brush own teeth
470161000124105| Denture cleaning declined
470401000124103| Independent cleaning of own dentures
472181000124101| Assistance required to clean own dentures

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References:
1 (Implementation of a structured oral hygiene program through nursing assistant education to address non-ventilator hospital-acquired pneumonia: A quasi-experimental study - PubMed
(nih.gov)
2 Non-ventilator health care-associated pneumonia (NV-HAP): Best practices for prevention of NV-HAP - American Journal of Infection Control (ajicjournal.org)

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