The Use of Guidelines for the Empiric Treatment of Hospital‐Acquired Pneumonia

Miletin, M; Chan, Charles K.

doi:10.1155/2001/713457

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…In another study of HCAP, receipt of empiric therapy not recommended by guidelines was independently associated with mortality after adjusting for other variables [24]. Most studies, however, fail to demonstrate significant correlations between compliance and outcomes [13,19-21]. Our findings on the relationships between compliance and outcomes are reported separately [25].…”

Section: Discussionmentioning

confidence: 68%

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Development and implementation of a performance improvement project in adult intensive care units: overview of the Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study

et al. 2011

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Introduction: In 2005 the American Thoracic Society and Infectious Diseases Society of America (ATS/IDSA) published guidelines for managing hospital-acquired pneumonia (HAP), ventilator-associated pneumonia (VAP), and healthcare-associated pneumonia (HCAP). Although recommendations were evidence based, collective guidelines had not been validated in clinical practice and did not provide specific tools for local implementation. We initiated a performance improvement project designated Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) at four academic centers in the United States. Our objectives were to develop and implement the project, and to assess compliance with quality indicators in adults admitted to intensive care units (ICUs) with HAP, VAP, or HCAP.

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Section: Discussionmentioning

confidence: 68%

“…Compliance rates were variable partly because of differences in study methods. In validation studies, compliance rates for empiric therapy were 49% [21] and 58% [20]. In the third validation study [22], overall compliance with standard operating procedures (SOPs) was reported as either higher or lower than 70%.…”

Section: Discussionmentioning

confidence: 99%

Development and implementation of a performance improvement project in adult intensive care units: overview of the Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study

et al. 2011

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“…The current study, unlike others [40], did not find any association with decreased mortality, at a time when hospital staffing, including consultants, allied healthcare specialties and management, may be more limited (weekends and holidays, 18:00-08:00 h). Another possible advantage to high-volume care or pre-admission consultation is timely, appropriate, antibiotic administration [41,42]. Finally, highvolume practitioners may simply be better able to anticipate problems, rather than react postoccurrence.…”

Section: Discussionmentioning

confidence: 99%

Mortality during hospitalisation for pneumonia in Alberta, Canada, is associated with physician volume

Marrie

Carrière²,

Jin³

et al. 2003

Eur Respir J

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The association of mortality with patient factors (severity of illness, comorbidity), physician factors (specialty training, prehospitalisation visit, in-hospital consultation, volume of patients seen per physician) and healthcare organisation factors (patient-travel distances, regional beds per capita, admitting hospital-bed occupancy, admitting hospital-bed turnover, hospital location, volume of pneumonia cases per hospital) after hospital admission with community-acquired pneumonia was investigated using administrative data from Alberta, Canada from April 1, 1994-March 31, 1999.During the 5-yr study period there were 43,642 pneumonia hospitalisations, with an 11% in-hospital and 26% 1-yr mortality. Patient severity of illness and comorbidity were the strongest predictors of increased mortality. Physicians with the highest inhospital pneumonia patient volume (w27 patients?yr -1 ) cared for patients with greater severity/comorbidity, but with decreased odds of in-hospital mortality, compared with the lowest volume physicians (less than seven patients per year).The effects of internal medicine specialist or subspecialist care were mixed, with a reduction in deaths for the first 72 h and an increase in in-hospital deaths. Prehospitalisation visit by a physician was associated with decreased mortality. Healthcare organisation factors were the least strong predictor of mortality, demonstrating an effect only for 1-yr mortality in those discharged alive from hospital. Admissions to larger volume or metropolitan hospitals were associated with a decrease in mortality.Severity of illness and comorbidity had the strongest association with mortality. The first association of high-volume physician and pre-hospital care with decreased inhospital mortality for community-acquired pneumonia is reported. Eur Respir J 2003; 22: 148-155.

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“…Appropriate antibiotics alter mortality in hospitalized community‐acquired pneumonia (8). However, empiric antibiotic therapy guidelines for community‐acquired pneumonia are variably followed (9, 10). Considerable variation exists in outpatient antibiotic prescribing practice for community‐acquired pneumonia (11) perhaps, in part, because better outcomes from prescribing appropriate antibiotics have not been well documented.…”

Section: Introductionmentioning

confidence: 99%

Appropriate antibiotic utilization in seniors prior to hospitalization for community-acquired pneumonia is associated with decreased in-hospital mortality

Johnson¹,

Carrière

Jin

et al. 2004

J Clin Pharm Ther

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The Use of Guidelines for the Empiric Treatment of Hospital‐Acquired Pneumonia

Abstract: Institutional and ATS guidelines for the empirical treatment of HAP are less widely used than would be predicted by chance at The University Health Network. The clinical utility of these guidelines remains to be proven.

Cited by 6 publications

References 22 publications

Development and implementation of a performance improvement project in adult intensive care units: overview of the Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study

Development and implementation of a performance improvement project in adult intensive care units: overview of the Improving Medicine Through Pathway Assessment of Critical Therapy in Hospital-Acquired Pneumonia (IMPACT-HAP) study

Mortality during hospitalisation for pneumonia in Alberta, Canada, is associated with physician volume

Appropriate antibiotic utilization in seniors prior to hospitalization for community-acquired pneumonia is associated with decreased in-hospital mortality

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