title: Pneumonia management in the intensive care setting.
abstract: This article describes a quality process adapted to continuously improve compliance for the core measure of pneumonia. This process began at a large tertiary/trauma hospital in Pittsburgh, Pennsylvania. Like any quality process, the pneumonia committee learned about each pneumonia measure so that a process could be designed for nursing staff to become compliant. This committee took the identified issues from nursing staff and worked on making timely changes to hospital systems. The pneumonia measure is challenging because the discharge diagnosis needs to be pneumonia; however, the committee decided to aggressively screen admitted or transferred patients who had a diagnosis of pneumonia and those at high risk for pneumonia. The advanced practice nurse follows all patients and reviews the electronic medical record for positive testing and treatments. The intensive care patients who had a diagnosis of respiratory failure or sepsis needed to be evaluated on a daily basis for the signs or symptoms of pneumonia. This measure includes patients whose primary diagnosis could be a respiratory failure or sepsis with a secondary diagnosis of pneumonia. Therefore, updates of chest radiographs or sputum cultures provided by the nursing staff and/or the nurse practitioner in the unit are helpful in making sure that all measures were completed. A list of identified issues and resolution of these issues is included in this article.
authors.affiliation: Performance Improvement Department, Allegheny General Hospital, 320 E N Avenue, Pittsburgh, PA 15212, USA. sleining@wpahs.org
authors.forename: Susan
authors.initials: S
authors.lastname: Leininger-Hogan
mesh_terms: D003266:Continuity of Patient Care; D019983:Guideline Adherence; D006801:Humans; D007362:Intensive Care Units; D009722:Nurse Practitioners; D010360:Patient Transfer / Q000458:organization & administration; D010414:Pennsylvania; D011014:Pneumonia / Q000451:nursing*; D011367:Professional Staff Committees; D058996:Quality Improvement