Improved treatment of community-acquired pneumonia through tailored interventions: Results from a controlled, multicentre quality improvement project

Autor:	Christian von Plessen, Anne-Marie Blok Hellesøe, Britta Tarp, Markus Fally, Line Molzen, Lise Notander Clausen, Pernille Ravn, Simone Bastrup Israelsen, Lilian Kolte, Emma Diernaes, Thomas Benfield, Regitze Seerup, Jacob Anhøj
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Male Medical Doctors Pulmonology Physiology Health Care Providers Denmark Psychological intervention Nurses Pilot Projects Infographics Severity of Illness Index Pneumonia/diagnostic imaging 0302 clinical medicine Community-acquired pneumonia Antibiotics Medicine and Health Sciences Medicine Medical Personnel 030212 general & internal medicine Prospective Studies Prospective cohort study Aged 80 and over Multidisciplinary Evidence-Based Medicine Antimicrobials Respiration Mortality rate Drugs Middle Aged Charts Quality Improvement Anti-Bacterial Agents Community-Acquired Infections Professions Female Guideline Adherence Patient Care Bundles Research Article Computer and Information Sciences medicine.medical_specialty Death Rates Science Microbiology 03 medical and health sciences Population Metrics Microbial Control Physicians Severity of illness Humans Aged Patient Care Bundles/standards Pharmacology Treatment Guidelines Health Care Policy Population Biology business.industry Data Visualization Community-Acquired Infections/diagnostic imaging Biology and Life Sciences Pneumonia Evidence-based medicine Guideline medicine.disease Health Care Anti-Bacterial Agents/therapeutic use 030228 respiratory system People and Places Emergency medicine Population Groupings Physiological Processes business
Zdroj:	PLoS ONE, Vol 15, Iss 6, p e0234308 (2020) Fally, M, Von Plessen, C, Anhøj, J, Benfield, T, Tarp, B, Clausen, L N, Kolte, L, Diernaes, E, Molzen, L, Seerup, R, Israelsen, S, Hellesøe, A M B & Ravn, P 2020, ' Improved treatment of community-acquired pneumonia through tailored interventions : Results from a controlled, multicentre quality improvement project ', PLOS ONE, vol. 15, no. 6, e0234308 . https://doi.org/10.1371/journal.pone.0234308 Fally, M, von Plessen, C, Anhøj, J, Benfield, T, Tarp, B, Clausen, L N, Kolte, L, Diernaes, E, Molzen, L, Seerup, R, Israelsen, S, Hellesøe, A-M B & Ravn, P 2020, ' Improved treatment of community-acquired pneumonia through tailored interventions : Results from a controlled, multicentre quality improvement project ', PLOS ONE, vol. 15, no. 6, e0234308 . https://doi.org/10.1371/journal.pone.0234308 Fally, M, von Plessen, C, Anhøj, J, Benfield, T, Tarp, B, Clausen, L N, Kolte, L, Diernaes, E, Molzen, L, Seerup, R, Israelsen, S, Hellesøe, A-M B & Ravn, P 2020, ' Improved treatment of community-acquired pneumonia through tailored interventions : Results from a controlled, multicentre quality improvement project ', PLoS ONE, vol. 15, no. 6, e0234308 . https://doi.org/10.1371/journal.pone.0234308 PLoS ONE
ISSN:	1932-6203
Popis:	BACKGROUND: Community-acquired pneumonia (CAP) is one of the leading causes of healthcare utilisation and death worldwide. Treatment according to evidence-based clinical guidelines can reduce mortality, antibiotic exposure and length of hospital stay related to CAP.LOCAL PROBLEM: Several studies, including a pilot study from one of our sites, indicate that physicians show a low grade of guideline adherence when managing patients with CAP.METHODS: To improve the guideline-based treatment of patients with CAP admitted to hospital, we designed a quality improvement study. Four process indicators were combined in a CAP care bundle: chest X-ray, CURB-65 severity score, lower respiratory tract samples and antibiotics within 8 hours from admission. After a 4-month baseline period, we applied multiple interventions at three hospitals during 8 months. Progression in our process indicators was measured continuously and compared with a control site without interventions. After the 8-month intervention period, we continued with a 4-month follow-up period to assess the sustainability of the improvements.RESULTS: The care bundle utilisation rate within 8 hours increased from 11% at baseline to 41% in the follow-up period at the intervention sites, whereas it remained below 3% at the control site. The most considerable improvements have been observed regarding documentation of CURB-65 (34% at baseline, 68% at follow-up) and the collection of lower respiratory tract samples (43% at baseline, 63% at follow-up).CONCLUSION: Our study has demonstrated poor adherence to CAP guidelines at all sites at baseline. After implementing multiple tailored interventions, guideline adherence increased substantially. In conclusion, we recommend that CAP guidelines should be actively adapted in order to be followed in a daily routine.
Databáze:	OpenAIRE
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