Why ReddyPort | ReddyPort

Why ReddyPort® Oral Care products

Why ReddyPort®?

Without ReddyPort®, Compliant BiPAP® Oral Care is a challenge: According to APIC, to decolonize the mouth, “Brush/swab with suction for 1-2 min using liquid cleansing/antiseptic solution about every 4 h or 6 times/d.” Without ReddyPort®, bedside clinicians are unable to deliver oral care for a full 1-2 minutes without risking patient’s lung compliance. Shortened duration oral care during mask removal is ineffective in decolonizing the mouth. Source
Mitigate risk of Hypoxia and lung compliance: With ReddyPort®, mask removal to deliver oral care is unnecessary, thus eliminating the risk that “Hypoxemia may occur when a patient is being switched from NIV to another device to perform oral care, posing a significant risk.” Source
265% higher NV-HAP Rates with BiPAP®: The infection rate of NV-HAP is 265% higher in NIV patients compared to hospital patients! “The incidence of pneumonia in all hospitalized patients is low at 0.85%. The incidence is much higher in patients receiving NIV (3.1%).” Source
How quickly does the oral cavity colonize with bacteria? Evidence shows “.[8] The bacterial cells colonize on the tooth surface within 4 hours of the pellicle formation. The initial colonizers being the Streptococci (S. viridens, S. mitis, S. oralis).” Ref: Biofilm and Dental Implant: The Microbial Link P.6
Why are NV-HAP rates with BiPAP so much higher? “Oral colonization with gram negative pathogens may be a prelude to HAP owing to pulmonary aspiration of the oral flora. The sources are not clear but likely include subgingival dental plaque, peridontal spaces, and the upper gastrointestinal tract.6 Inhalation of oropharyngeal flora into the respiratory tract can cause an inflammatory response ending in endothelial and epithelial injury to the lung parenchyma and pneumonia. Source
Control Healthcare Costs: “Developing NV-HAP was associated with a 20.53 (20.39, 20.67) day longer length of stay, a 2.73 (95% CI: 2.48, 3.0) OR for 30-day mortality, a 2.12 (2, 2.26) OR for 1-year mortality, a 34.18 (27.62, 42.29) OR for inpatient sepsis, a $63,995.33 (63,754.5, 64,236.15) increase in total 1-month costs, and a $100,858.61 (100,250.54, 101,466.67) increase in total mean 12-month costs. Source
Unplanned Mask Removal and Pressure Injuries: Patient discomfort often results in the removal of the mask by clinicians or patients in order to provide relief. However, this may lead to alveolar collapse and worsening respiratory status. Unplanned removal of the mask can lead to improper fitting that increasing the risk of pressure injuries.
EMR Charting of Oral Care: SNOMED CT Oral Care Codes are now listed in the International Release (2023) and available for your Hospital’s EMR for efficient documentation of BiPAP® oral care procedures that can be tied to outcomes.

470071000124104 | Changed to Brushing of teeth declined
470391000124100 | Independent brushing of own teeth
472171000124104 | Assistance required to brush own teeth
470161000124105 | Denture cleaning declined
470401000124103 | Independent cleaning of own dentures
472181000124101 | Assistance required to clean own dentures

Why Oral Care is a “Standard of Care Intervention”

Joint Commission Recommendation: Oral Care is the Standard of Care. Call to Action includes: “Overcome beliefs that NVHAP prevention strategies such as oral hygiene and mobility are optional tasks rather than standard-of-care interventions.” Source
CDC Recommendation: Hospitals should incorporate oral care for NV-HAP prevention, Oct 2023 Oral care in hospitalized patients is a low risk, low-cost intervention, which potentially reduces NV-HAP and leads to the additional benefits of improved oral health. For these reasons, hospitals should incorporate comprehensive oral care into patient care protocols for non-ventilated patients. Source
NV-HAP has high mortality rates: “Patients who develop NV-HAP are over 8 times more likely to die than their equally ill matched controls who do not develop NV-HAP.” Ref: Reducing Missed Opportunities to prevent NV-HAP pg 48
“Nonventilator hospital-acquired pneumonia in a patient receiving NIV also increases the risks of endotracheal intubation and death.” Source
NV-HAP leads to Sepsis: Referenced study demonstrates that sepsis impacts 36% of all NV-HAP patients. “In the 2012 calendar year, 119,075 adults had NV-HAP develop; sepsis developed in 36.3% of these cases.” Ref: Sepsis in the Context of NV-HAP pg 9. Source
Why is Compliant Oral Care Essential? “This nurse-led oral-care initiative has reduced NV-HAP incidence by 60% and saved the hospital more than $2 million over 1 year.” Source
Oral Care is “Primary Driver #1 for NV-HAP Prevention.” AJIC NV-HAP Prevention Best Practices. Source
APIC: Oral Care is the Standard of Care. “Routine oral care following evidence-based oral care protocol should be a fundamental part of patient care to reduce NV-HAP risk related to oropharyngeal colonization.” Source

References:
1. Quick Safety Preventing non-ventilator hospital acquired pneumonia Issue 61 September 2021. 2. Oral Health in Healthcare Settings to Prevent Pneumonia Toolkit https://www.cdc.gov/hai/prevent/Oral-Health-Toolkit.html. October 2023 3. Oral Care in Critically Ill Patients Requiring NIV pg 67 4. Oral Care in Critically Ill Patients Requiring NIV pg 67 5. Sepsis in the Context of NV-HAP pg 9 6. American Nurse Today Vol10 No3 pg 19 7. JIC NV HAP Prevention Best Practices pg. A24 8.. Oral Care in Critically Ill NIV patients P69 9. AJIC NV HAP Prevention Best Practices pg. A26 10. AJIC “Association of NV-HAP and Patient Outcomes…” pg 1343 11. Oral Care in Critically Ill Patients Requiring Noninvasive Ventilation: An Evidence-Based Review Jace, et al pg. 69