학술논문

A bundled approach to care: reducing the incidence of postoperative pneumonia in patients undergoing hepatectomy and Whipple procedures
Document Type
Report
Source
Canadian Journal of Surgery. February, 2021, Vol. 64 Issue S1, pE9, 5 p.
Subject
Canada
Language
English
ISSN
0008-428X
Abstract
Postoperative occurrence of pneumonia can increase lengths of stay, risk of morbidity and death and health care costs. At Toronto General Hospital, we identified a high incidence of postoperative pneumonia in patients undergoing hepatectomy and Whipple procedures in 2016. To reduce the incidence of postoperative pneumonia, we implemented an evidence-based bundle approach in 2017. The bundle included the following components: oral care, incentive spirometry, coughing and deep breathing, physical activity, elevation of the head of the bed, and patient and family education. In addition to the bundle components, we provided staff education and created patient education and monitoring tools to ensure competency and compliance with the bundle components. Data collected as part of the National Surgical Quality Improvement Program were reviewed to monitor progress. In this article, we discuss our approach, aimed to reduce the incidence of postoperative pneumonia and associated health care costs in the general surgery population.
Postoperative pneumonia is a common hospital-acquired infection associated with substantial morbidity and death. Although most approaches focus on the prevention of ventilator-associated pneumonia (VAP), (1) only 39.1% of postoperative pneumonia [...]