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  1. Mouth is a potent source of infection in hospitalised patients/ HAI 
  2. Infections in the mouth are a combination of many factors; point of entry of microbes, biofilm formed by oral secretions, poor dentition/ mucosal ulcers in sick patients, presence of foreign bodies, eg. ET tubes, NG tubes, concomitant immunosuppression 
  3. Existing standard procedure of using saline for irrigation, suction using suction machine, and cleaning using a brush has several disadvantages. Suction machine has to be dragged to every patient-physical labour, spread of infection, looking for electrical sockets. The reservoir collects multiple patient secretions- source of HAI. The suction catheters need to be discarded properly, and are BULKY to carry and dispose. 

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 The oral cavity is a potent focus of infection, harbouring many germs especially anaerobic bacteria. Especially in ventilated patients, the artificial airway bypasses the normal channels of infection control. A similar situation exists in patients with nasogastric tubes. Even without these channels, infection risk is present and increases with duration of hospitalisation and degree of immunosuppression. Mouth infection is a cycle of events; oral secretions form a biofilm which shields germs, which, in turn, propagate the secretions and biofilm. Therefore oral care is a must for every hospitalised patient. 

 In every patient, the mouth care element consists of irrigation, manual friction (brushing) and suction.  Suction is provided by connecting to a suction machine, which, in turn, requires an electrical point. A suction machine has to be dragged from patient to patient, thereby, resulting in unnecessary contact and spread of infection. Also, the reservoir of suction fluids collected for different patient secretions is common, leading to spread of infection.  In addition, the physical effort of dragging a suction machine from bed to bed is an unnecessary burden on nursing staff.  The reservoir, too, needs to be emptied frequently; this task is critical to prevent multiplication of organisms. 

Also, suction catheters are bulky, clumsy, require careful handling, and spread secretions easily; the nurse needs to wear gloves during use. Also the suction catheter can damage the oral mucosa due to the stiff material as well the force of the suction apparatus. This will further worsen infections. 

Additionally, a suction machine requires servicing, cleaning, etc. If there is a power outage, this crucial aspect of patient care may get neglected. More importantly, the suction machine provided to wards is meant to be used for critical care; during Cardiopulmonary Resuscitation and care of endotracheal tube. Use for oral care is misdirected use, especially in view of the potential for spread of infection. The ideal solution is to provide nurses with a disposable, convenient handheld system, which carries minimal risk of cross infection, and does not require electrical power. 

The solution- STERIMOUTH

 Sterimouth is a portable, compact, lightweight, handheld system for oral care in bed bound patients; including unconscious patients. It is sealed, disposable, with zero contact of the nurse’s hands with patient saliva; even gloves are not required. Therefore, it minimises the spread of infection, to and from the patient. It is convenient to the nurse, being a closed system; with no contact with patient secretions. The kit is very compact, flexible, easily fits into the pocket before and after use. Multiple, used kits can be placed back in the pocket between patient to patient and discarded together. Thus it becomes easy to attend to many patients at a time. 

Sterimouth has a soft, flexible catheter/ handle tipped with a non-traumatic, antimicrobial impregnated toothbrush. Patient secretions are sucked out through the toothbrush and enter a sterile, disposable reservoir.  It does not cause injury; if there is existing injury it reduces the chance of secondary infection. Moreover, it can be used even in patients with face injury who cannot open the mouth fully; being thin and flexible it can easily be inserted in such patients. 

Moreover there is no need to use a suction machine or look for a power source. Therefore there is no need to carry suction apparatus and waste disposal bin from patient to patient. 

 In summary, the advantages of Sterimouth are 

  • Reduces spread of infection
  • Disposable, compact, hand-operated system
  • Convenient for nurses, therefore wide acceptance. Even gloves not required.
  • No oral trauma during use
  • Freedom from suction apparatus and electrical connection
  • Use in patients with face/ jaw injury
  • Zero maintenance, including cleaning.