Although it is the most common hospital-acquired infection, hospitals are not required to report non-ventilator-associated hospital-acquired pneumonia to the CDC National Healthcare Safety Network.
A task force of health care leaders recently published a national call to action, urging increased focus on the prevention of non-ventilator-associated, hospital-acquired pneumonia (NVHAP).
Most hospitals do not have systems in place to track or report NVHAP, according to a press release. Furthermore, most health systems do not have active prevention initiatives, even though NVHAP is the most common hospital-acquired infection.
NVHAP has significant negative patient outcomes, including 15% to 30% mortality rates, extended hospital lengths of stay, unexpected intensive care unit admissions of up to 46%, and an increased risk for hospital readmission within 30 days, according to the press release.
Unlike cases of pneumonia associated with ventilators and other device-associated hospital-acquired infections, NVHAP is not recognized as an indicator in the National Database of Nursing Quality, and the Centers for Medicare and Medicaid Services do not require hospitals to report cases to the CDC National Healthcare Safety Network. NVHAP is also not included in pay-for-reporting or performance programs.
“Adding NVHAP to these lists of high-stakes conditions is one way to draw hospitals’ attention to NVHAP, to catalyze the discovery of optimized prevention initiatives and implementation strategies, and drive down NVHAP incidence and morbidity,” the white paper said, according to the press release.
NVHAP is a major research focus for Karen K. Giuliano, PhD, RN, FAAN, MBA, a member of the task force and an associate professor at the University of Massachusetts Amherst. Giuliano worked with other task force members to develop recommendations to improve research and prevention efforts to reduce harm from NVHAP, according to the press release.
In addition to raising awareness, the white paper recommends educating patients, health care professionals, and students about prevention measures. These strategies can include standardized, therapeutic oral care for all patients, implementing surveillance strategies, and supporting research to develop new strategies for both surveillance and prevention.
“The hidden harm from NVHAP in acute care is a significant patient safety issue,” Giuliano said in the press release. “NVHAP should be elevated to the same level of concern, attention, and effort as prevention of [ventilator-associated pneumonia] in hospitals.”
The call to action was developed by a joint task force of health care stakeholders, including the CDC, the Veterans Health Administration, the Joint Commission on Accreditation of Healthcare Organizations, the American Dental Association, the Patient Safety Movement Foundation, Oral Health Nursing Education and Practice and the Teaching Oral-Systemic Health program. It was published in Infection Control & Hospital Epidemiology.
Health Care Leaders Call for National Focus on Preventing Hospital-Acquired Pneumonia. News release. University of Massachusetts Amherst. June 22, 2021. Accessed June 23, 2021. https://www.umass.edu/news/article/health-care-leaders-call-national-focus-preventing-hospital-acquired-pneumonia