Miss Georgia Matterson1,2, Dr Katrina Browne1,2, A/Professor Philip Russo1,4,5, A/Professor Helen Rawson4, Professor Brett Mitchell1,2,3
1Avondale University, Cooranbong, Australia, 2Central Coast Local Health District, Gosford, Australia, 3Hunter Medical Research Institute, Newcastle, Australia, 4Monash University, Clayton, Australia, 5Cabrini Health, Malvern, Australia
Biography:
Georgia Matterson is a research assistant at Avondale University and an integral member of the Infection Prevention Research Group. Georgia has a Bachelor of Biotechnology (Honours I) from Newcastle University and received the 2022 College Medal. Her research focuses on clinical trials to prevent healthcare-associated infections.
Abstract:
Introduction
Non-ventilator hospital-associated pneumonia (HAP) is the most common healthcare-associated infection (HAI), however it is often underreported and under-researched. Oral care is a key intervention that may reduce HAP incidence. The Hospital-Acquired Pneumonia PrEveNtion (HAPPEN) trial is a world-first, multi-centre, randomised controlled trial (RCT) exploring whether improving the quality and frequency of oral care can reduce HAP rates. The trial includes co-design, implementation, and translation phases to inform education, resources, and practice change.
Methods
HAPPEN incorporates three phases. Phase 1 (Co-design) engaged clinicians, consumers and stakeholders in a national survey and focus groups to identify optimal oral care strategies and informed resource development applied during Phase 2 (Implementation). Phase 2 involved a multi-centre stepped-wedge RCT in nine wards, in three Australian hospitals (NSW and VIC) over 12 months. The intervention was to improve oral care, through assisting with oral care delivery, staff education, patient engagement and training resources, supported by research nurses on each ward. The primary outcome was the incidence of HAP. Phase 3 (Translation) will evaluate the cost-effectiveness of the intervention and development of high-quality accessible HAP prevention resources for clinicians and patients.
Results
Phase 1 results have been published. Phase 2 was completed in August 2025, with approximately 12,000 patients included in the RCT. Results for Phase 2 are expected in 2026. Phase 3 begins in 2026.
Conclusions
The HAPPEN trial will provide high-quality evidence on oral care and HAP prevention. Findings will inform resources, education, and guidelines, with the goal of improving patient care and outcomes.