Non-Ventilator Associated Hospital-Acquired Pneumonia (NV-HAP) is a leading infection in hospitals across the country, responsible for 60% of all hospital-acquired pneumonia cases. Veterans who develop NV-HAP during hospital stays face an increased risk of mortality, longer recovery periods, and complications such as sepsis—challenges that can dramatically impact their health and quality of life.
Recognizing this critical issue, the Hospital Acquired Pneumonia Prevention by Engaging Nurses (HAPPEN) program offers a proactive and innovative approach to prevent NV-HAP by enhancing oral care practices during hospital stays.
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Reimagining Care: Oral Health as a Lifesaving Intervention
HAPPEN was created by a team of nurses at the Salem VA Medical Center who identified an urgent need for consistent oral care services to reduce the risk of NV-HAP among hospitalized Veterans. This nurse-led initiative is supported by dental professionals and focuses on improving oral health through:
- Daily oral care routines: Nurses provide consistent oral care at least twice a day for Veterans in hospitals and long-term care settings.
- Education and awareness: Veterans are empowered to understand the direct connection between oral health and pneumonia prevention.
- Documentation and monitoring: Facilities track both oral care practices and NV-HAP rates to ensure continuous, high-quality care.
Each case of NV-HAP prevented through the HAPPEN program saves an estimated $100,000 in annual health care costs while reducing the need for prolonged hospital stays and intensive medical interventions.
“HAPPEN demonstrates the power of VA’s engaged frontline nursing workforce to identify an opportunity, develop an evidence-based solution and scale that innovation across the nation,” said Dr. Sheila Cox-Sullivan, director of Research Evidence-Based Practices and Analytics in VA’s Office of Nursing Services.
Real Results: Scaling Innovation Nationwide
The success of HAPPEN is undeniable. In its first year at Salem VA’s long-term care units, the program led to a 92% decrease in NV-HAP cases among Veterans. Building on this success, HAPPEN earned national recognition during the VHA Shark Tank competition in 2015, which allowed it to replicate its model at the Houston VA Medical Center.
With support from the VHA Diffusion of Excellence Program and VA’s Office of Rural Health, HAPPEN expanded to all VA medical centers nationwide by July 2021. The results have been transformative:
- VA facilities that implemented HAPPEN reported an average 40-60% decrease in NV-HAP cases.
- The program reduced hospital stays, lowered health care costs, and enhanced the quality of life for Veterans.
In recognition of its national impact, the American Academy of Nursing named HAPPEN an Academy Edge Runner in September 2024, honoring its success in saving lives and improving care outcomes for hospitalized Veterans.
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What’s Next for HAPPEN?
As a proven model for preventing NV-HAP, HAPPEN continues to inspire health care systems to adopt proactive approaches to oral care. By leveraging nurse-led innovation, the program exemplifies VA’s commitment to delivering high-quality, Veteran-centered care that saves lives and drives meaningful change.
Learn More About HAPPEN
- Explore HAPPEN’s impact on the Diffusion Marketplace.
- Read more about the program’s recognition as an Academy Edge Runner.
- Learn about VA’s broader efforts to drive innovation in Veteran care by visiting the VHA Innovation Ecosystem.
For further insights, check out the 2024 VHA State of Innovation Report, subscribe to the weekly VA Innovation newsletter, and explore VA Pathfinder to discover opportunities for innovation across the VA health care system.
Together, initiatives like HAPPEN are transforming Veteran care, one step—and one smile—at a time.
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