Pneumonia: New Standards in Diagnosis & Care
By Kim Maryniak, PhD, RNC-NIC, NEA-BC
In most situations, pneumonia is preventable and treatable! Adopting a few simple habits can protect the community and healthcare workers from pneumonia. For example: Community-acquired pneumonia prevention includes:
• Hand hygiene
• Cover coughs and sneezes
• Limit contact with sick people
• Getting vaccinated
• Stop smoking
• Limit contact with second-hand smoke
Hospital-acquired pneumonia prevention includes
• Hand hygiene
• Routine oral care for patients
• Mobilize patients at least twice a day
• Utilizing incentive spirometers and coughing and deep
(American Lung Association (ALA), 2018)
It is important for healthcare workers to know that pneumonia recognition, prevention, diagnosis and treatment have changed based on recent research findings. The categories of pneumonia based on where the pneumonia was contracted have been reduced. The current categories of pneumonia are:
• Community-acquired (CAP)
• Hospital-acquired (HAP)
• Ventilator-associated (VAP)
• Healthcare- associated pneumonia (HCAP) has been removed from the list because the diagnosis has not been found to sensitive and specific to identifying at risk patients
(IDSA/ATS Guidelines 2016 in Kenny, 2016)
Originally treatment guidelines were written by both the Infectious Diseases Society of America and the American Thoracic Society. However, in 2007, the guidelines were merged to ensure that care would be standardized. These two groups met again to update the CAP guidelines – to be released in late 2018, and HAP/VAP guidelines in 2016. These new guidelines are intended to help increase pneumonia recognition, reduce unnecessary diagnostic testing, and reduce treatment times. They are not meant to supplant the physician’s judgement as the guidelines cannot account for individual variation among patients or special clinical situations. Hence, they are to be used as a treatment adjunct (IDSA/ATS Guidelines 2016 in Kenny, 2016).
Some of the changes in the guidelines include recommendations for treatment medications, treatment length, oral care, elevation of the head of the bed, gastrointestinal protection, patient mobility, and suctioning.
The RN.com courses: Pneumonia: Emerging Trends in Diagnosis & Care, Assessment Series: Focused Pulmonary Assessment and Assessment Series: Pulmonary Anatomy and Physiology will provide interested healthcare providers with the newest research on pneumonia identification, prevention, and treatment.
American Lung Association (ALA). (2018). Pneumonia symptoms, causes, and risk factors. Retrieved from: http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/pneumonia/symptoms-causes-and-risk.html
Kenny, J. (2016). ISDA Guidelines 2016: HAP, VAP & it’s the end of HCAP as we know it (and I feel fine). Retrieved from: https://pulmccm.org/infectious-disease-sepsis-review/idsa-guidelines-2016-hap-vap-end-hcap-know-feel-fine/
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