DOI: 10.1101/19007336Oct 10, 2019Paper

Implementation of a specialist pneumonia intervention nurse service significantly lowers mortality for community acquired pneumonia

MedRxiv : the Preprint Server for Health Sciences
R. C. FreeGerrit Woltmann

Abstract

Objectives: Evaluate clinical outcomes associated with implementing a specialist pneumonia intervention nursing (SPIN) service, to improve adherence with BTS guidelines for hospitalised community acquired pneumonia (CAP). Design: Retrospective cohort study, comparing periods before (2011-13) and after (2014-16) SPIN service implementation. Setting: Single NHS trust across two hospital sites in Leicester City, England Participants: 13,496 adult (aged [&ge;]16) admissions to hospital with a primary diagnosis of CAP Interventions: The SPIN service was set up in 2013/2014 to provide clinical review of new CAP admissions; assurance of guidelines adherence; delivery of CAP clinical education and clinical follow up after discharge. Main outcome measures: The primary outcomes were proportions of CAP cases receiving antibiotic treatment within 4 hours of admission and change in crude in-hospital mortality rate. Secondary outcomes were adjusted mortality rate and length of stay (LOS). Results: The SPIN service reviewed 38% of CAP admissions in 2014-16. 82% of these admissions received antibiotic treatment in <4 hours (68.5% in the national audit). Compared with the pre-SPIN period, there was a significant reduction in both 30-day (OR=0.7...Continue Reading

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