RT Journal Article
SR Electronic
T1 Specialist pneumonia intervention nurse service improves pneumonia care and outcome
JF BMJ Open Respiratory Research
JO BMJ Open Resp Res
FD British Thoracic Society
SP e000863
DO 10.1136/bmjresp-2020-000863
VO 8
IS 1
A1 Free, Robert C
A1 Richardson, Matthew
A1 Pillay, Camilla
A1 Hawkes, Kayleigh
A1 Skeemer, Julie
A1 Broughton, Rebecca
A1 Haldar, Pranabashis
A1 Woltmann, Gerrit
YR 2021
UL http://bmjopenrespres.bmj.com/content/8/1/e000863.abstract
AB Background A specialist pneumonia intervention nursing (SPIN) service was set up across a single National Health Service Trust in an effort to improve clinical outcomes. A quality improvement evaluation was performed to assess the outcomes associated with implementing the service before (2011–2013) and after (2014–2016) service implementation.Results The SPIN service reviewed 38% of community-acquired pneumonia (CAP) admissions in 2014–2016. 82% of these admissions received antibiotic treatment in <4 hours (68.5% in the national audit). Compared with the pre-SPIN period, there was a significant reduction in both 30-day (OR=0.77 (0.70–0.85), p<0.0001) and in-hospital (OR=0.66 (0.60–0.73), p<0.0001) mortality after service implementation, with a review by the service showing the largest independent 30-day mortality benefit (HR=0.60 (0.53–0.67), p<0.0001). There was no change in length of stay (median 6 days).Conclusion Implementation of a SPIN service improved adherence to BTS guidelines and achieved significant reductions in CAP-associated mortality. This enhanced model of care is low cost, highly effective and readily adoptable in secondary care.No data are available. This manuscript was the result of a service improvement exercise. Consequently, we do not have ethical approval to share the data used to produce the conclusions in this paper.