2.50
Hdl Handle:
http://hdl.handle.net/10755/211690
Type:
Research Study
Title:
CLINICAL ATTRIBUTES OF NON VENTILATOR-ASSOCIATED HOSPITAL-ACQUIRED PNEUMONIA
Abstract:
Aims: To describe the incidence, demographics, and clinicopathologic characteristics of patients with non ventilator-associated hospital-acquired pneumonia (non-VAP HAP). Background: Numerous studies have reported on the incidence and prevention of ventilator-associated pneumonia (VAP); conversely non-VAP HAP is an underreported and unstudied area, with potential for measureable nurse-sensitive outcomes.  With the National Healthcare Safety Network focus on VAP, hospitals are required to monitor VAP; however there are currently no requirements to monitor non-VAP HAP.  The limited studies available indicate that non-VAP HAP is an emerging factor in prolonged hospital stays and patient morbidity.  Understanding the incidence and determining patients most at risk of this hospital-acquired infection is essential to provide optimal patient care. Methods: Non ventilator-associated hospital-acquired pneumonia data were obtained from a large, urban hospital’s electronic integrated medical management system.  Inclusion criteria were all adult discharges between January 1, 2010 and December 31, 2010, coded pneumonia, not present on admission and meeting the Centers for Disease Control and Prevention’s algorithm for hospital-acquired pneumonia.  Descriptive statistics were used to determine the age, gender, ethnicity, season, length of stay, primary diagnosis for admission, and disposition upon discharge. Results: There were 24,482 adult admissions during the study period with 191 patients coded with hospital-acquired pneumonia.  The mean age was 66 +15.75 and there were more males than females (56.5% vs. 43.5%).  Cases were evenly distributed over the four seasons (Fall 25.1%, Winter 24.6%, Spring 28.6%, Summer 21.6%).  The mean length of stay was 23 +35.61 days.  Sepsis was the most frequent primary diagnosis (14.1%), followed by acute myocardial infarction (9%), acute myeloid leukemia without remission (3.5%), and cardiac valve disease (3%).  The most frequent disposition upon discharge was home (46.2%), expired (22.9%), or long term care (20.6%).  Five patients were discharged with the remaining 10.3% of discharges. Implications: This study confirms that non-VAP HAP did occur in a large, urban hospital should be monitored.  Hospital-acquired pneumonia occurred most frequently in elderly, male, seriously ill patients.  After an extended length of stay, almost half of patients recovered and were discharged directly to home. In addition, 43.5% either expired or were discharged to a long-term care facility.  More research across institutions is required to understand and design nursing interventions to prevent non-VAP HAP iatrogenic disease.
Keywords:
non Ventilator-associated pneumonia; non-VAP HAP
Repository Posting Date:
20-Feb-2012
Date of Publication:
20-Feb-2012
Other Identifiers:
4897
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typeResearch Studyen_GB
dc.titleCLINICAL ATTRIBUTES OF NON VENTILATOR-ASSOCIATED HOSPITAL-ACQUIRED PNEUMONIAen_GB
dc.identifier.urihttp://hdl.handle.net/10755/211690-
dc.description.abstractAims: To describe the incidence, demographics, and clinicopathologic characteristics of patients with non ventilator-associated hospital-acquired pneumonia (non-VAP HAP). Background: Numerous studies have reported on the incidence and prevention of ventilator-associated pneumonia (VAP); conversely non-VAP HAP is an underreported and unstudied area, with potential for measureable nurse-sensitive outcomes.  With the National Healthcare Safety Network focus on VAP, hospitals are required to monitor VAP; however there are currently no requirements to monitor non-VAP HAP.  The limited studies available indicate that non-VAP HAP is an emerging factor in prolonged hospital stays and patient morbidity.  Understanding the incidence and determining patients most at risk of this hospital-acquired infection is essential to provide optimal patient care. Methods: Non ventilator-associated hospital-acquired pneumonia data were obtained from a large, urban hospital’s electronic integrated medical management system.  Inclusion criteria were all adult discharges between January 1, 2010 and December 31, 2010, coded pneumonia, not present on admission and meeting the Centers for Disease Control and Prevention’s algorithm for hospital-acquired pneumonia.  Descriptive statistics were used to determine the age, gender, ethnicity, season, length of stay, primary diagnosis for admission, and disposition upon discharge. Results: There were 24,482 adult admissions during the study period with 191 patients coded with hospital-acquired pneumonia.  The mean age was 66 +15.75 and there were more males than females (56.5% vs. 43.5%).  Cases were evenly distributed over the four seasons (Fall 25.1%, Winter 24.6%, Spring 28.6%, Summer 21.6%).  The mean length of stay was 23 +35.61 days.  Sepsis was the most frequent primary diagnosis (14.1%), followed by acute myocardial infarction (9%), acute myeloid leukemia without remission (3.5%), and cardiac valve disease (3%).  The most frequent disposition upon discharge was home (46.2%), expired (22.9%), or long term care (20.6%).  Five patients were discharged with the remaining 10.3% of discharges. Implications: This study confirms that non-VAP HAP did occur in a large, urban hospital should be monitored.  Hospital-acquired pneumonia occurred most frequently in elderly, male, seriously ill patients.  After an extended length of stay, almost half of patients recovered and were discharged directly to home. In addition, 43.5% either expired or were discharged to a long-term care facility.  More research across institutions is required to understand and design nursing interventions to prevent non-VAP HAP iatrogenic disease.en_GB
dc.subjectnon Ventilator-associated pneumoniaen_GB
dc.subjectnon-VAP HAPen_GB
dc.date.available2012-02-20T12:08:40Z-
dc.date.issued2012-02-20T12:08:40Z-
dc.date.accessioned2012-02-20T12:08:40Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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