Improving Core Measure Compliance for Community-acquired Pneumonia

Résumé du livre

Each year more than 600,000 people are admitted to hospitals with community acquired pneumonia (CAP). Three quarters are admitted through the emergency department. In order to assure that patients with CAP receive quality care, the Joint Commission for Accreditation of Hospitals (JCAHO), developed seven core measures to guide assessment and treatment of CAP. The Committee for Medicaid and Medicare Services (CMS) and Infectious Disease Society of America (IDSA) support the core measure of administering an antibiotic within four hours of arrival to the ED. Research has shown a decrease in mortality when this is accomplished. Emergency department staff struggles to administer the first antibiotic within the four hour time frame due to hospital overcrowding and avoidable treatment delays. Research has shown that with the use of evidence-based guidelines patient mortality decreased, length of stay decreased, patients who are a low-risk of dying could be safely treated at home, and the cost of health care decreased. Emergency department (ED) staff was informed of current research that demonstrated how core measures apply to their practice. The staff was taught how to recognize symptoms of CAP, how to utilize a pneumonia order-set to initiate care and, how to use the pneumonia severity index (PSI) to determine who can be treated safety at home. The staff was educated about antibiotics that have been chosen to treat CAP. Finally the ED staff was informed that the hospital and emergency department's leadership aspire for compliance with core measures. A pre-test and post-test were administered before and after the teaching session. The scored on the post-test were higher than the teaching session. The scores on the post-test were higher than the pre-test demonstrating an increase in knowledge about core measures for CAP.