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Clear and compelling evidence exists in the literature to suggest that nosocomial pneumonia is linked to poor oral care. In nursing homes and intensive care units, practicing good oral care has been demonstrated to reduce the risk of aspiration pneumonia (Furr, Binkley, McCurren, & Carrico, 2004). In an oral care program implemented in a 29-bed rehabilitation unit, lung status was improved in 77% of patients who were admitted with aspiration pneumonia. Key components of the forces of magnetism (American Nurses Credentialing Center, n.d.) were used to implement the program, including autonomy and interdisciplinary relationships. The rehabilitation unit also applied the theory proposed by Higgins and Howell, which promotes using champions to make important process changes (1990). This article reviews the steps one rehabilitation unit took to implement an oral care plan.

We thank Dr Csont and Dr Ferdinandy for their interest in our work.1 In principle, we agree that it is possible and even likely that more that one factor controls the complex events that accompany myocardial infarction (MI). Nevertheless, we have clearly shown that mortality, frequency of ventricular ruptures, and hemodynamic dysfunction were significantly increased 3 weeks post MI in bgn −/ 0 mice.1 These findings prove that absence of biglycan …