Implementing a community acquired pneumonia care bundle in the acute hospital setting
E. Ramhamadany, S. Wlson, P. Eardley, J. Cheema, J. Johnson, K. Dohkia, M. Kay, R. Grant, M. Shamat, E. Ramhamadany, B. Mann, Z. Mirza (Isleworth, Middlesex, United Kingdom)
Source: Annual Congress 2011 - The new clinical spectrum of lung diseases: from bronchi to pleura
Disease area: Respiratory infections
Abstract Objective: The aims are to reliably deliver clinically effective and timely treatment in the management of CAP (community Acquired Pneumonia), to reduce overall variances in care, and to improve the quality of patient care and outcomes.Methods: Using Improvement Methodology techniques the project team: Conducted a base line audit, mapped out current patient journey, arranged education sessions for relevant staff members, used a locally customised CAP bundle pack, and used the PDSA Cycle and the sustainability tools. A multi professional group, including patient representative, used a bespoke reporting tool to record weekly measures of bundle compliance. Non compliance was disseminated to the team for response and feedback. Project team meetings were held weekly, this gave the opportunity for all to monitor progress.Results: A base line audit of 50 patients was compared with 200 patients in the CAP Care Bundle, over18 months. There was an improvement in providing written information to patients from 0 to 88%, documenting the CURB-65 CAP severity score 32% to 94%, oxygen correctly prescribed 78% to 88%, timely administration of antibiotics within 4 hours of arrival to hospital from 54% to 88%, and antibiotic following BTS guidelines from 48% to 87%.Implications: Implementing a Care Bundle Pathway can improve patients care, but a high degree of perseverance is required to implement changes and sustain improvements. The success cannot be dependant on only a few champions but needs to have support from the organisation at all levels. The project was funded and supported by NW London CLAHRC.
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E. Ramhamadany, S. Wlson, P. Eardley, J. Cheema, J. Johnson, K. Dohkia, M. Kay, R. Grant, M. Shamat, E. Ramhamadany, B. Mann, Z. Mirza (Isleworth, Middlesex, United Kingdom). Implementing a community acquired pneumonia care bundle in the acute hospital setting. Eur Respir J 2011; 38: Suppl. 55, 491
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