A Retrospective Study of Non-Ventilator-Associated Hospital Acquired Pneumonia Incidence and Missed Opportunities for Nursing Care

J Nurs Adm. 2018 May;48(5):285-291. doi: 10.1097/NNA.0000000000000614.

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.

MeSH terms

  • Adult
  • Aged
  • Cross Infection / epidemiology
  • Cross Infection / nursing*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Nurse's Role*
  • Nursing Methodology Research
  • Nursing Staff, Hospital / organization & administration*
  • Pneumonia, Bacterial / epidemiology
  • Pneumonia, Bacterial / nursing*
  • Retrospective Studies
  • Risk Factors
  • United States
  • Young Adult