Sustaining Quality Improvement: Long-Term Reduction of Nonventilator Hospital-Acquired Pneumonia.

Abstract:

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.

journal_name

J Nurs Care Qual

authors

Baker D,Quinn B,Ewan V,Giuliano KK

doi

10.1097/NCQ.0000000000000359

subject

Has Abstract

pub_date

2019-07-01 00:00:00

pages

223-229

issue

3

eissn

1057-3631

issn

1550-5065

journal_volume

34

pub_type

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