期刊
JOURNAL OF NURSING CARE QUALITY
卷 34, 期 3, 页码 223-229出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/NCQ.0000000000000359
关键词
nonventilator hospital-acquired pneumonia; nursing care; oral health; quality improvement
类别
资金
- Sage Products LLC
Background: Hospital-acquired pneumonia is now the number one hospital-acquired infection. Hospitals have addressed ventilator-associated pneumonia; however, patients not on a ventilator acquire more pneumonia with significant associated mortality rates. Local Problem: In our hospital, non-ventilator-associated pneumonia was occurring on all types of units. Methods: The Influencer Model was used to reduce nonventilator hospital-acquired pneumonia rates. Statistical process control R and X-bar-charts were monitored monthly. Interventions: After a gap analysis, an interdisciplinary team implemented enhanced oral care before surgery and on the units, changed tube management, and monitored stress ulcer medication. Results: We achieved a statistically significantly reduction (P = .01) in pneumonia rates that have been sustained over 4 years. Conclusions: Sustaining change requires (a) a continued team-based, collaborative approach, (b) ongoing stakeholder and executive leadership engagement, (c) monitoring that easy-to-use protocols and required equipment remain in place, and (d) embedded analytics to monitor results over a prolonged period.
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