Nonventilator hospital-acquired pneumonia: A call to action

Abstract

Executive Summary In 2020 a group of U.S. healthcare leaders formed the National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) to issue a call to action to address non–ventilator-associated hospital-acquired pneumonia (NVHAP). NVHAP is one of the most common and morbid healthcare-associated infections, but it is not tracked, reported, or actively prevented by most hospitals. This national call to action includes (1) launching a national healthcare conversation about NVHAP prevention; (2) adding NVHAP prevention measures to education for patients, healthcare professionals, and students; (3) challenging healthcare systems and insurers to implement and support NVHAP prevention; and (4) encouraging researchers to develop new strategies for NVHAP surveillance and prevention. The purpose of this document is to outline research needs to support the NVHAP call to action. Primary needs include the development of better models to estimate the economic cost of NVHAP, to elucidate the pathophysiology of NVHAP and identify the most promising pathways for prevention, to develop objective and efficient surveillance methods to track NVHAP, to rigorously test the impact of prevention strategies proposed to prevent NVHAP, and to identify the policy levers that will best engage hospitals in NVHAP surveillance and prevention. A joint task force developed this document including stakeholders from the Veterans’ Health Administration (VHA), the U.S. Centers for Disease Control and Prevention (CDC), The Joint Commission, the American Dental Association, the Patient Safety Movement Foundation, Oral Health Nursing Education and Practice (OHNEP), Teaching Oral-Systemic Health (TOSH), industry partners and academia.

Incidence, Outcomes and Sex-Related Disparities in Pneumonia: A Matched-Pair Analysis with Data from Spanish Hospitals (2016–2019)

“…However, VAP only represents a fraction of all HAPs. Indeed, voices have been raised to implement strategies to reduce the impact of non-ventilator-associated HAP (NV-HAP) [6]. Although updated guidelines to treat both conditions have been issued [7], some authors have argued that some of the recommendations given are not based on high-quality evidence [8].…”

Recommendations for change in infection prevention programs and practice

“…Nonventilator hospital acquired pneumonia (NV-HAP) is the most common hospital acquired infection in the US affecting 1% of hospitalized patients with a crude mortality rate of 15%-30%. 123,124 NV-HAP is associated with a significantly longer length of stay, high 30day readmission rates, a greater need for intensive care management and long-term care following discharge, increased direct care costs, and perhaps most importantly, it is a frequent source of sepsis. [124][125][126] As noted in a September 2021 Joint Commission Safety Briefing, NV-HAP is a substantial threat to patient safety and a large driver of health care cost, yet it is not formally tracked or reported to the National Database of Nursing Quality Indicators or the CDC NHSN nor does it impact the Centers for Medicare and Medicaid Services payfor-reporting or performance programs.…”

The Influence of Atrial Fibrillation on In-Hospital Mortality in People with Hospital-Acquired Pneumonia: An Observational, Sex-Stratified Study

“…However, VAP only represents a small fraction of all HAPs [ 3 ]. Some experts have claimed that there is a need to implement strategies to reduce the impact of not ventilator-associated HAP (NV-HAP), which continues to be an important cause of mortality even in fully developed countries [ 4 ].…”