Journal Article

Use of Indicators to Evaluate the Quality of Community-Acquired Pneumonia Management

Dilip Nathwani, Fiona Williams, John Winter, Janet Winter, Simon Ogston and Peter Davey

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 34, issue 3, pages 318-323
Published in print February 2002 | ISSN: 1058-4838
Published online February 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/323186
Use of Indicators to Evaluate the Quality of Community-Acquired Pneumonia Management

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Quality-assessment indicators for community-acquired pneumonia (CAP) founded on health care structure, process, and outcome have been recommended as a potential audit tool to evaluate the delivery of care. We prospectively audited the treatment of 205 patients admitted with CAP to 2 hospitals in Dundee against some of these key standards. Patients with severe CAP were more likely to die (mortality rate, 42% versus 7%) and to receive antibiotics by the intravenous route (relative risk [RR], 1.81; 95% confidence interval [CI], 1.38–2.37) and within 4 hours of admission to the hospital (RR, 1.22; 95% CI, 0.92–1.62). There was a lack of uniformity regarding the amount of oxygen prescribed, with evidence of poor case record and drug prescription chart documentation related to oxygen therapy. Adherence to the recommended antibiotic policy was associated with reduced risk of death or readmission to the hospital (RR, 0.58; 95% CI, 0.34–1.00). However, in a multivariate analysis, severity of pneumonia was the strongest predictor of death or readmission (P = .004), and adherence to the antibiotic policy was not statistically significant (P = .154). Our study has confirmed the value of quality indicators in evaluating our CAP management and has stimulated the development and implementation of a local hospital—based integrated care pathway.

Journal Article.  3867 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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