• Virginia Prendergast, Cindy Kleiman, and Mary King.
• Division of Advanced Practice Nursing, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. Neuropub@dignityhealth.org
• Intensive Crit Care Nurs. 2013 Oct 1; 29 (5): 282-90.

AimTo introduce the Bedside Oral Exam (BOE) and the Barrow Oral Care Protocol (BOCP) to guide oral care for intensive care unit patients. Secondary aim: To explore quality improvement data for incidence of ventilator associated pneumonia (VAP), cost effectiveness of oral hygiene supplies and staff response to change in practice.MethodsDescriptive case design for implementation and evaluation of oral assessments and oral hygiene. Incidence of VAP and the cost of oral care supplies before and after implementation was compared. Staff responses were elicited both pre- and post-implementation.ResultsIncidence of VAP fell significantly from 4.21 to 2.1 per 1000 ventilator days (p =.04). A cost savings of 65% was noted on a monthly basis for oral hygiene supplies. Staff reported increased satisfaction in providing oral hygiene with a combination of oral care products.ConclusionsA significant reduction in VAP was noted using the BOCP. The BOE guided individualised oral care with contemporary supplies, including a tongue scraper, electric toothbrush, non-foaming toothpaste and oral moisturisers. Cost-effective, comprehensive oral care appears to be effective in reducing VAP. Further studies are needed to assess impact of oral hygiene on oral health and patient comfort.Copyright © 2013 Elsevier Ltd. All rights reserved.

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