Effect of a simple educational intervention on the hospital management of community-acquired pneumonia.
OBJECTIVE
Both the speed of commencement and the appropriateness of i.v. antibiotic administration influence outcomes in patients hospitalized with community-acquired pneumonia (CAP). While quality improvement projects have been linked to better CAP management and outcomes, there are limited data evaluating simple and achievable interventions.


METHODS
A simple educational programme targeting rapid and appropriate antibiotic administration for the inpatient treatment of CAP was evaluated using a retrospective chart review of all patients admitted through the emergency department with CAP during 'pre-intervention' and 'post-intervention' periods.


RESULTS
There were 108 pre-intervention patients (56 women, median age 63 years) and 88 post-intervention patients (43 women, median age 61 years) included in the evaluation. Comparison of indicators of care in the post-intervention period with those in the pre-intervention period showed there were significant changes in: median time to antibiotic administration (2.5 h vs 3.5 h, 95% CI: 0-1.25, P = 0.01); subjects not prescribed macrolide antibiotics (2.3% vs 10.2%, 95% CI for OR 1.02-46.19, P = 0.04); hospital length of stay (3.5 vs 6 days, 95% CI: 1-3, P < 0.001) and mortality (0% vs 6.5%, 95% CI for OR 1.13 to infinity, P = 0.02).


CONCLUSIONS
A simple, inexpensive educational intervention was associated with significant improvements in the hospital management of CAP. The widespread introduction of similar programmes has the potential to effect substantial improvements in management, and possibly patient outcomes, and requires prospective confirmation in a larger, randomized sample.
Serisier
David J
DJ
Department of Respiratory Medicine, Mater Adult Hospital, Brisbane, Queensland, Australia. david_serisier@mater.org.au
Bowler
Simon D
SD
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017714:Community-Acquired Infections / Q000188:drug therapy*; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007902:Length of Stay; D018942:Macrolides / Q000627:therapeutic use*; D008297:Male; D008505:Medical Staff, Hospital / Q000193:education*; D008875:Middle Aged; D011014:Pneumonia / Q000188:drug therapy*; D011787:Quality of Health Care; D012189:Retrospective Studies; D013997:Time Factors
D000900:Anti-Bacterial Agents; D018942:Macrolides