Arlington, VA, January 9, 2018 -- Hospital-acquired pneumonia has long been associated with the elderly and intensive care units (ICU). But according to a new multicenter nationwide study , nonventilator hospital-acquired pneumonia (NV-HAP) occurs across all units in all types and sizes of U.S. hospitals, putting every patient--the young included--at higher risk for developing the infection.
The findings, published in the January issue of the American Journal of Infection Control (AJIC), the journal of the Association for Professionals in Infection Control and Epidemiology ( APIC ), reviewed patient data across 21 US hospitals, retroactively pulling charts from January 1, 2014 through December 31, 2014 to identify NV-HAP cases, in addition to assessing demographic data, outcomes, and documented preventive interventions applied.
The research team flagged 1,300 patients who acquired NV-HAP, recording a NV-HAP incidence rate of 0.12-2.28 cases per 1,000 patient days. The study is one of the first to debunk the association that NV-HAP predominantly impacts the elderly, and reverses previously held notions that patients in the ICU are at greatest risk for contracting pneumonia.
Here's what the researchers found:
"NV-HAP does not discriminate; all patients across all hospital floors face a risk for acquiring pneumonia," said Dian Baker, PhD, RN, the study's lead author and a school nurse program coordinator at the California State University School of Nursing. "But from standardizing oral care protocols to tracking hospital-wide NV-HAP rates, providers can address gaps to identify new or reinforce existing preventive measures. We predict that with the right interventions to cut NV-HAP rates in half, hospitals could save roughly 10 thousand lives, 490,000 hospital days and $2.43 billion in costs per year."
Up to 35.4 million US patients are at risk for NV-HAP annually--as compared to 3.9 million patients at risk for ventilator-associated pneumonia (VAP). And while both healthcare-associated infections (HAI) have a roughly 19 percent mortality rate, NV-HAP costs health systems some $156 million, in contrast to the $86 million attributed to VAP costs. Patients with NV-HAP are 8.4 times more likely to require intensive care and/or die during hospitalization; 8.0 times more likely to require mechanical ventilation and, on average, have a readmission rate of 19.3 percent.
"Healthcare-acquired pneumonia is an under-appreciated HAI, causing patient harm, deaths, and excess healthcare costs," said 2018 APIC President Janet Haas, PhD, RN, CIC, FSHEA, FAPIC. "However, since this infection is often preventable through nursing care activities aimed at preventing aspiration, once we recognize this problem, we can improve. This study underscores the need to implement evidence-based practices known to prevent pneumonia throughout the hospital."
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Visit http://www.apic.org to learn more information about preventing infections in healthcare facilities.
American Journal of Infection Control