Pneumonia - Long Term Care

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Pneumonia is a big problem in care facilities. Did you know that good oral care can decrease incidence of pneumonia by 21%! That's just the beginning of how oral care can increase the health of dependent adults.

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Pneumonia:

Pneumonia Oral biofilm management for health

1998:

1998 A verage cost for people over age 65 with community acquired pneumonia is $7166. Clin Ther . 1998 Jul-Aug;20(4):820-37. The cost of treating community-acquired pneumonia.

2004:

2004 R oughly 915,900 cases of community-acquired pneumonia occur annually among seniors in the United States.

2004:

2004 Approximately 1 of every 20 persons aged 85 years or over will have a new episode of community-acquired pneumonia each year

2006:

2006 There is good evidence to show that improved oral hygiene and frequent professional oral health care reduces the progression or occurrence of respiratory diseases among high-risk elderly adults living in nursing homes… J Periodontol . 2006 Sep;77(9):1465-82. Systematic review of the association between respiratory diseases and oral health.

Immunocompetent Seniors :

Immunocompetent Seniors

Higher risk for Community-Acquired Pneumonia :

Higher risk for Community-Acquired Pneumonia

Nursing Home Acquired Pneumonia:

Nursing Home Acquired Pneumonia 30-day mortality rates ranging from 10 to 30%

Slide 9:

A study looking at the charts of 528 persons with NHAP transferred to acute hospitals for treatment found that advance directives were present only 6.4 % of the time .

Slide 10:

Given the high 1-year mortality rate for NHAP, clinicians caring for nursing home residents should make it a priority to ensure that advance directives are in place. These should be readily available to help with the decision on whether or not the resident should be transferred to a hospital, and must also accompany the patient to the acute care facility. You know when you hear it.

Slide 11:

All Due to Biofilm

Typical bacterial pathogens :

Typical bacterial pathogens Streptococcus pneumoniae ( penicillin-sensitive and-resistant strains ) Haemophilus influenzae (ampicillin-sensitive and -resistant strains) Moraxella catarrhalis (all strains penicillin-resistant).

Typical bacterial pathogens attributed to pneumonia :

Typical bacterial pathogens attributed to pneumonia

The airway is very close to the mouth – ahem.:

The airway is very close to the mouth – ahem.

Slide 16:

Mouth

Slide 17:

Montana State University Center for Biofilm Engineering used with permission

2005:

2005 Calculation of population-based attributable fractions showed that 21% of all cases of pneumonia in our cohort could have been avoided if inadequate oral care and swallowing difficulty were not present .

~ $15,000 Per person with NHAP:

~ $15,000 Per person with NHAP

Contributing to Nursing Home Acquired Pneumonia:

Contributing to Nursing Home Acquired Pneumonia

Contributing to NHAP These two can be addressed by a licensed dental hygienist:

Contributing to NHAP These two can be addressed by a licensed dental hygienist

Slide 22:

A dental hygienist a ssisting with oral care can save thousands of dollars.

To Summarize:

To Summarize

Conclusion:

Conclusion Pneumonia is expensive Oral care can decrease incidence by 20% Nursing home acquired pneumonia leads to death

Call to Action:

Call to Action Find out the limitations of dental hygienists in your state. Strive for a mandate that all Long Term Care Facilities funded by Medicaid have an independent dental hygienist as the Director of Dental Hygiene, a DDH.

Credits:

Credits PowerPoint designed by Cross Link Presentations, LLC Presentation design Shirley Gutkowski, RDH, BSDH, FACE Script Shirley Gutkowski, RDH, BSDH, FACE Photos: Dreamstime , Gutkowski, Stone Images: Montana State University Center for Biofilm Engineering Characters: PresenterMedia Copyright 2011 Exploring Transitions, LLC

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