Background:
Life-threatening mucosal barrier injury central line-associated bloodstream infections (MBI-CLABSIs) are an especially dangerous complication of inadequate oral healthcare and associated with a 7% 30-day mortality rate.1 Oral complications among pediatric cancer patients can be due to treatment-induced side effects, limited access to dental care, nonadherence to oral care guidelines, and variations in oral care practices.1–4 Our innovative approach to addressing oral complications and infection prevention strategies led to hiring a dental hygienist to serve in a novel Oral Health Educator (OHE) role.
Methods:
This project used MBI-CLABSI and oral hygiene bundle adherence rates from October 2021 to September 2022. MBI-CLABSIs were identified if the causative species was a known oral or GI pathogen and met the National Healthcare Safety Network definition.5 The aims of this project were to decrease MBI-CLABSI incidence by 25%, improve oral care adherence to remain above 75%, and decrease healthcare-associated costs on the bone marrow transplant (BMT) unit.
Results:
The overall MBI-CLABSI rate after OHE implementation decreased 59% and decreased consistently to 0/1000-line days for June to September 2022 (Figure 1). Overall MBI-CLABSI events decreased by 56%. Oral care bundle adherence remained consistently above 75% after OHE implementation. We estimate a 6 month associated healthcare cost savings of $230,000.
Fig. 1.
Conclusions:
The OHE contributed to standardizing oral hygiene protocols, improving patient, family, and staff education, reinforcing adherence with oral care protocols, and facilitating dental referrals. These interventions have contributed to reduced MBI-CLABSI rates, improved oral hygiene bundle adherence, and reduced associated healthcare costs for high-risk pediatric BMT patients.
DISCLOSURE
The authors have no financial interest to declare in relation to the content of this article.
Footnotes
Our institution received a charitable donation from the Schiel B-R-C-P-B-B-L Foundation to fund employment of a dedicated Oral Health Educator. No additional funds were received toward this project.
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