A postoperative pneumonia prevention program for patients in the surgical ward at a California Veterans Affairs hospital lowered the case rate for the condition, which can cause significant complications and increase the cost of care.
Pneumonia is a common infection that accounts for about 15 percent of all hospital-acquired infections and as much as 3.4 percent of complications among surgical patients.
The study outlines the results (2008-2012) for a postoperative pneumonia prevention program for patients who were not on a mechanical ventilator in the hospital's surgical ward. The prevention program had several components, including ongoing education for surgical ward nursing staff on pneumonia prevention, coughing and deep-breathing exercises with incentive spirometer, twice daily oral hygiene with chlorhexidine, walking, sitting up to eat and elevated head-of-bed.
Between 2008 and 2012, there were 18 cases of postoperative pneumonia among 4,099 at-risk hospitalized patients for a case rate of 0.44 percent. That is a 43.6 percent decrease from the hospital's preintervention rate of 0.78 percent. Pneumonia rates in all years were lower than the preintervention rate (0.25 percent, 0.50 percent, 0.58 percent, 0.68 percent and 0.13 percent in 2008-2012, respectively).
"Despite the limitations listed earlier, our study supports the concept that successful and sustained reduction of pneumonia among postoperative patients requires multiple performance measures and unrelenting standardized quality improvement efforts."
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JAMA Surgery. Published online July 23, 2014. DOI: 10.1001/jamasurg.2014.1216