Audit of a multidisciplinary approach to improve management of community-acquired pneumonia

Abstract

BackgroundCommunity-acquired pneumonia (CAP) is a frequent cause of morbidity, mortality and hospital admission worldwide. An adequate choice of empirical antibiotic treatment and appropriate severity assessment of the disease are key aspects in the management of CAP.ObjectiveTo audit the adherence to standards of care, such as empirical prescribing of antibiotics, and evaluate the current multidisciplinary approach to the management of CAP.MethodRecords of patients with CAP were identified and examined for CURB65 score documentation, discussion notes with microbiology and prescribed antibiotic treatments.ResultsOut of the 62 patients identified, 32 had a CURB65 score documented in their medical notes and 59 had documented chest X-ray findings. 85.5% of cases were compliant with antibiotic prescribing guidelines.ConclusionThe multidisciplinary approach has considerably improved compliance with most of the standards, especially adherence to empirical antibiotic guidelines, and ultimately the standard of care for patients with CAP.

An audit of community-acquired pneumonia antimicrobial compliance using an intervention bundle in an Irish hospital

“…The decision to admit and the antimicrobial choice for CAP have been highly protocolised based on well-validated scoring systems, including CURB-65 for patients presenting to hospital [4] , [5] . Despite this, documentation of severity scores for unscheduled admissions has been poor [6] , [7] , [8] , [9] , [10] . Patients with low CURB-65 scores are admitted unnecessarily [11] .…”

Diagnosis and Therapy of Community-Acquired Pneumonia in the Emergency Department: A Retrospective Observational Study and Medical Audit

“…As evidenced by a study conducted in Italy by Costantini et al in 2012, adherence to both urinary antigen tests was reported at 55% for all patients [29]. Conversely, a study in the United Kingdom by Fahimi et al demonstrated a markedly lower compliance rate, with less than 20% of physicians adhering to the testing protocol [32]. In Ireland, both pre-and post-intervention results exhibited compliance rates below 20% and up to 40%, respectively [33].…”

“…This finding aligns closely with the results of other audits conducted in similar healthcare settings. For instance, at James Paget University Hospital in the United Kingdom, blood cultures were obtained for 84.2% of cases [32]. Likewise, at Sligo University Hospital in Ireland, the pre-interventional and post-interventional rates for blood culture collection were 84.4% and 62.5%, respectively [33].…”

“…Hospital internal clinical audits, if set up and carried out effectively, are powerful instruments in quality improvement [30,31]. A few audits on the quality of CAP management have been conducted in different countries in recent years, investigating different aspects of CAP management [32][33][34]. In Switzerland, a formal audit has-to our knowledge-not been published so far.…”

Modern approaches at the management of children with community-acquired pneumonia

“…Рекомендовано участие врачей-специалистов в диагностике и ведении детей с пневмонией в зависимости от тяжести течения заболевания и коморбидной патологии с целью эффективной терапии [70] (УУР -С; УДД -5). Диагностику и ведение пациентов с пневмонией обычно проводит врач-педиатр / врач общей практики (семейный врач), при необходимости проводятся консультации врача-пульмонолога, врача детского хирурга / врача торакального хирурга.…”