Improving Oral Care in the Hospital: Program HOPE.

Authors

Sumit Agarwal, Pooja Rangan, Anandalakshmi Ponnaluri, Robin Shepherd, Bhanu Bucchireddigari, Kanika Khandelwal, Sandeep Pagali, Nimit Agarwal

Published in

Journal of the American Geriatrics Society. Sep 02, 2026. Epub Sep 02, 2026.

Abstract

Oral care is a proven intervention for reducing non-ventilator-associated hospital-acquired pneumonia (NV-HAP) rates by 40%-60%. Comprehensive oral care education programs are not widely reported among hospital settings in the United States. We launched the nurse-driven Hospital Oral Care and Periodontal Disease Education (HOPE) program in July 2022 with an aim to establish evidence-based oral care protocols for hospitalized older adults to reduce NV-HAP.
This retrospective observational study evaluated the impact of the HOPE program, a quality improvement initiative, on oral care delivery, documentation rates, and the incidence of NV-HAP among hospitalized older adults over a 60-month period from January 2021 to December 2025.
About 33,155 hospitalized older adults were analyzed. Oral care documentation rates demonstrated significant improvements from pre-implementation to post-implementation across all age groups. The 65-74 age group exhibited improvement in documentation from 30% to 57%. Patients aged 75-84 demonstrated comparable trends, with overall documentation increasing from 31% to 58%. The ≥ 85 age group showed documentation rates increased from 30% to 56%. Both genders had similar trends, with females from 32% to 58% and males from 29% to 57%. The rates of NV-HAP remained similar across the pre-implementation phase (2.1%), Pilot phase (2.3%), and post-implementation phase (2.4%).
HOPE program improved oral care adherence and documentation, particularly for hospitalized older adults. The program's outcomes emphasize the importance of evidence-based standardized protocols, staff education, patient engagement, and a multidisciplinary approach to enhance patient safety across diverse patient populations.

PMID:
42686652
Bibliographic data and abstract were imported from PubMed on 03 Sep 2026.

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