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chronic obstructive pulmonary disease.

HAPPI team

Based on these findings and to help prevent HAP and other adverse events, our interprofessional group at Sutter Medical Center in Sacramento, California, began a HAP prevention initiative (HAPPI) in 2012. This nurse-led oral-care initiative has reduced NV-HAP incidence by 60% and saved the hospital more than $2 million over 1 year.

The HAPPI team includes staff from nursing, rehabilitation services, nutrition services, infection control, respiratory therapy, material supplies, and administration, in addition to physicians. The team meets monthly to plan, implement, and monitor the NV-HAP prevention program.

Initial steps included a gap analysis, which compared best practices and published guidelines with current nursing practices. Gaps revealed by the analysis helped determine what changes to make in nursing practice. (See What the gap analysis found.) The HAPPI team addressed each barrier to an effective oral-care program; interprofessional collaboration helped overcome these barriers.