Improving Oral Care to Reduce Hospital-Acquired Pneumonia (HAP) in the Acute Neurologically Impaired Adult

Inclusion Criteria: * Adult (\> 19 years) * Admitted to RCH neuroscience unit * Primary diagnosis is neurological (brain injury/insult) * Non-intubated * Dependent for oral care and unable to direct their own oral care Exclusion Criteria: * \< 19 years * Off service patients * Intubated, on bilevel positive airway pressure or continuous positive airway pressure devices, (respiratory assistive devices) * Palliative * Capable of directing their own oral care * Unable to receive oral care due to: oral tubes, nasal/oral airways, wired jaws, or behaviours such as resistiveness, combativeness, non-compliance, etc.