ABSTRACT
OBJECTIVE: To determine non-ventilator-associated hospital-acquired pneumonia (NV-HAP) incidence, assess negative impacts on patient outcomes and cost, and identify missed preventive nursing care opportunities. BACKGROUND: NV-HAP is inadequately studied and underreported. Missed nursing care opportunities, particularly oral care, may aid NV-HAP prevention. METHODS: This descriptive, observational, retrospective chart review identified adult NV-HAP cases and associated demographic and hospital care data. RESULTS: Two hundred five NV-HAP cases occurred in 1 year at Montefiore Medical Center, equating to an incidence of 0.47 per 1000 patient-days and an estimated excess cost of $8.2 million. ICU transfer following pneumonia occurred in 15.6% of cases. Care requirements from specialist nursing facilities increased at discharge (26.8%), as compared with care requirements on admission (17.6%). Complete nursing care documentation was missing for most patients, with oral care undocumented 60.5% of the time. CONCLUSIONS: Preventable NV-HAP cases and their negative impact on cost and patient outcomes may decrease through improved basic nursing care.
Subject(s)
Cross Infection/nursing , Nurse's Role , Nursing Staff, Hospital/organization & administration , Pneumonia, Bacterial/nursing , Adult , Aged , Cross Infection/epidemiology , Female , Humans , Incidence , Male , Middle Aged , Nursing Methodology Research , Pneumonia, Bacterial/epidemiology , Retrospective Studies , Risk Factors , United States , Young AdultABSTRACT
This column discusses a multifaceted approach to improve the care of hospitalized older adults.
