Date of Award


Document Type

Scholarly Project

Degree Name

Doctor of Nursing Practice (DNP)



First Advisor

Sarah M. I. Cartwright DNP, MSN-PH, BAM, RN-BC, CAPA, FASPAN

Second Advisor

Sandra Wolfe Citty, PhD, ARNP-BC, CNE


Practice Problem: Non-ventilator hospital acquired pneumonia (NV-HAP) is more common than ventilator acquired pneumonia. Oral care is the only modifiable risk factor for all patient populations.

PICOT: The PICOT question that guided this project was: In non-ventilated patients in a tertiary care setting (P), how does implementing an oral care bundle (I) compared to the current practice of individual tasks without a bundle (C) affect adherence to facility oral care standard of patients receiving oral care at least once a day (O) over six weeks (T)?

Evidence: Lack of an oral bundle that has been proven to decrease the delivery of oral care. Intervention: Implementation of an oral care bundle including a decision-making protocol, oral care products, staff and patient education, and proper care documentation competencies. Additionally, surveillance and auditing practices were established.

Outcome: There were considerable improvements in the delivery of oral care (42.07% increase for ≥ 1 oral care activity per patient day), patient education (18.29% increase during episode of care), and documentation (47.60% decrease in oral care documentation deficiency and 50.73% decrease in oral care education deficiency).

Conclusion: Inconsistent delivery of oral care can lead to significant health concerns and costs to patients and healthcare facilities. Consistently utilizing oral care practices, such as an oral care bundle, improved the delivery and documentation of oral care and patient education.


Scholarly project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice

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Creative Commons Attribution-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 License.