Cho Ray Hospital
Steps Taken to Introduce SARAYA OraCare Oral Care Sponge Brush
- How were implementing oral care prior to the introduction of the sponge brush?
Before the sponge brush was introduced, we used normal cottons to implement oral care. We changed the method and began to use a normal toothbrush with toothpaste. In 2018, when a hospital-wide ventilator-associated pneumonia (VAP) prevention program was introduced, we started using the OraCare Oral Care Sponge Brush (Saraya’s sponge brush).
- What was the deciding factor in choosing SARAYA OraCare Oral Care Sponge Brush? Were there any challenges you faced before this item was introduced in the hospital?
One of the two deciding factors was the implementation of a hospital-wide VAP prevention program. As per the program’s manual, it was necessary for us to use the sponge brush while implementing oral care to patients. Second, to keep pace with the evolution of technology in the country and around the world, we needed to incorporate new technology into our hospital. When the VAP prevention program was introduced, a Japanese infection prevention and control expert dispatched from the Japan International Cooperation Agency (JICA) provided us with guidance on how to use sponge brushes and perform oral care for patients. After going through the steps the expert detailed, Saraya’s sponge brushes are now used alongside a 0.12% chlorhexidine gluconate solution. As a result, the percentage of VAP infection has reduced from 28.4% to 11.7% since 2017 to 2024.
Prior to the introduction of Saraya’s sponge brush, it was difficult to adjust the amount of water for oral care—it was either too little or too much. One of the good points of Saraya’s sponge brushes is that they make it possible to control the amount of water impregnated into the sponge.
After the Introduction of the SARAYA OraCare Oral Care Sponge Brush
- What are your favorite points about Saraya’s sponge brush?
We heard that Saraya’s sponge brushes are easy to use and that the company pays particular attention to the shape of the shaft and the color of the sponge. I like that it is easy and convenient to use and that it fits very well in the patient’s mouth. Normally, many tubes are inserted into ventilated patients; thus, they don’t have enough space in the mouth. This sponge brush can reach even small spaces, making it possible to thoroughly clean the mouth. It is also very soft and flexible enough to be used in the mouth because it doesn’t irritate the gums.
- Which staff members use this item? When do they use it?
Nurses in the ward use it to implement oral care to patients twice a day, at around 7 a.m. and at 9 p.m.
- What kind of patient is Saraya’s sponge brush used on?
The sponge brush is used for the oral care of critically ill patients who are unconscious. First, the inside of the patient’s mouth is moisturized with Saraya’s sponge brush. Then, we clean the inside of the patient’s mouth until all the dirt is removed.
- Are all staff members able to use it properly?
Yes, all of this hospital nurses can use this product properly because all staff received training in its use. A Japanese expert who had been dispatched to our hospital as part of the JICA project gave us a lecture about oral care using a sponge brush. The staff came to the ICU-C and attended the lecture as part of their on-the-job training. The expert also gave us a manual from the National Center for Global Health and Medicine in Japan (NCGM) that included video clips, which we used to practice. I am also currently training ward staff.
- How has your work changed after introducing this item?
The work efficiency of our nurses has improved. Most importantly, the number of VAP cases has decreased since this product was introduced at the hospital.
Next Step
- Do you expect to face new challenges in oral care in the future?
To improve patient care, we must always consider incorporating new technologies, such as a brush that can be connected to the suction tube.