Long-term Results of a Postoperative Pneumonia Prevention Program for the Inpatient Surgical Ward

Abstract

The standardized pneumonia prevention program achieved substantial and sustained reduction in postoperative pneumonia incidence on our surgical ward; its wider adoption could improve postoperative outcomes and reduce overall health care costs.

Incidence and Risk Factors for Pneumonia After Posterior Lumbar Fusion Procedures

“…Their efforts yielded a postoperative pneumonia rate of 0.44%, considerably lower than national averages. 8 Similar prevention programs should become the standard of care in all hospitals, with particular attention being given to the patients identified here to be at greatest risk.…”

“…Such interventions include maintaining head elevation to at least 30 degrees, aggressive incentive spirometry, sitting upright for all meals, practicing oral hygiene with chlorhexidine 2 times per day, and supervised ambulation with effective pain control. 8 Kazaure et al 8 demonstrated the effectiveness of these interventions by implementing them as a standardized postoperative pneumonia prevention program for all non-cardiac surgical patients from 2008 to 2012. Their efforts yielded a postoperative pneumonia rate of 0.44%, considerably lower than national averages.…”

Impact of specific postoperative complications on the outcomes of emergency general surgery patients

“…The framework for the development of process measures that are specific for the prevention of nosocomial pneumonia already exists. 10,11 Perhaps, best known are ''Wake Up and Breathe'' protocols, which encourage the daily coupling of spontaneous awakening trials and spontaneous breathing trials in mechanically ventilated patients to reduce the incidence of ventilator-associated pneumonia. 10 In addition, Kazaure et al 11 recently reported the successful implementation of a pneumonia prevention program at their tertiary care center, which focused on nonintubated surgical patients who required only intermediatelevel care.…”

“…10,11 Perhaps, best known are ''Wake Up and Breathe'' protocols, which encourage the daily coupling of spontaneous awakening trials and spontaneous breathing trials in mechanically ventilated patients to reduce the incidence of ventilator-associated pneumonia. 10 In addition, Kazaure et al 11 recently reported the successful implementation of a pneumonia prevention program at their tertiary care center, which focused on nonintubated surgical patients who required only intermediatelevel care. This program, which included basic steps such as incentive spirometer use, aggressive ambulation, and proper head-of-bed position, was credited with reducing the incidence of postoperative pneumonia among ward patients at their center by 43.6% during a 5-year period.…”

The Epidemiology and Risk Factors for Postoperative Pneumonia

“…Currently, postoperative pneumonia is the third most common complication for all surgical procedures and is associated with increased patient morbidity and mortality [1]. Furthermore, it prolongs length of stay (LOS) by a mean of 7 - 9 days as well as increases medical costs ranging from $12,000 to $40,000 [2-4].…”