Using Quality Improvement Techniques for the Prevention of Nosocomial Pneumonia

Royal University Hospital Saskatoon, Saskatchewan, Canada 

Nosocomial pneumonias are the second most frequently reported hospital-acquired infection, accounting for 16% to 19% of all nosocomial infections and affecting approximately 300,000 patients in the United States each year (1). The overall or crude mortality rate is 30% (90,000 deaths), and the direct or attributable mortality rate is 10% (30,000 deaths). Therefore, one-third of the deaths are directly due to the pneumonia and two-thirds to the underlying diseases (2). Furthermore, the extra length of hospital stay directly attributable to the pneumonias is estimated to be 9 days (2.7 million patient-days per year in the United States). Thus, morbidity rates, mortality rates, and direct costs are great. For these reasons, prevention of nosocomial pneumonias is clearly of great importance. 

Specific risk factors such as those related to the host, device, or environment and those related to therapeutic measures such as stress ulcer prophylaxis are discussed elsewhere. This chapter discusses the roles of staff education, quality control (QC), quality assurance (QA), and continuous quality improvement (CQl) on reducing the rates of nosocomial pneumonia. Quality control usually refers to laboratory tests, such as pulmonary function tests, and deals with eliminating variation and errors in the testing process. Quality assurance is a term referring to the activities of people and has been replaced by the 

Marcel Dekker, Inc. 270 Madison Avenue, New York, New York 10016 

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Using Quality Improvement Techniques for the Prevention of Nosocomial Pneumonia... 

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