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A Strategy to Prevent Postoperative Pneumonia

Postoperative pneumonia continues to create a burden on healthcare systems, often leading to increases in morbidity, length of hospital stay, and costs. Postoperative pneumonia is the third most common complication among surgical patients and is the third most common infectious complication after urinary tract and wound infections. Despite the availability of effective antibiotics, published research indicates that mortality rates associated with hospital-acquired pneumonia due to gram-negative infection are between 25% and 50%. The overall prognosis for patients experiencing postoperative pneumonia is poor, due in part to comorbidities.  “Postoperative pneumonia is the third most common complication among surgical patients and is the third most common infectious complication after urinary tract and wound infections.” According to the Institute for Healthcare Improvement, a facility that performed 10,000 non-cardiac operations per year would be expected to have about 150 cases of postoperative pneumonia. In the ICU, this complication can translate into additional healthcare costs of as much as $40,000 per patient; the estimated mortality rate ranges from 20% to 70%. Throughout the country, pneumonia-prevention programs have been successfully implemented in ICU settings. However, there are currently no such programs in place for patients in surgical wards. An Effective Pilot Program In the April 2010 Journal of the American College of Surgeons, my colleagues and I reported a study in which we tested a pilot pneumonia-prevention program to assess its effect on reducing the incidence of postoperative pneumonia in a hospital surgical ward. The pilot prevention program was designed and implemented based on an extensive literature review of risk reduction interventions. In the program, physicians and ward staff received education on preventing pneumonia. Other...
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