Hospital-acquired infections (HAIs) have long posed significant challenges in healthcare settings, despite rigorous federal initiatives aimed at reducing them. Some of the commonly focused HAIs include catheter-associated urinary tract infections (CAUTIs), central line-associated bloodstream infections (CLABSIs), Clostridioides difficile infections (CDI), surgical site infections (SSIs) specific to colon surgeries and abdominal hysterectomies, and methicillin-resistant Staphylococcus aureus (MRSA) Bacteremia.
In order to motivate hospitals to enhance their infection control efforts, certain programmes such as the Centers for Medicare and Medicaid Service’s (CMS) Value-based Purchasing (VBP) use HAIs outcome measures to adjust payments to hospitals. Points of interest include the CMS hospital-acquired condition (HAC) penalty, which takes into account hospitals’ HAI reporting and extends to other HACs.
However, one common HAI yet to be specifically included in these measures is hospital-acquired pneumonia (HAP) particularly, non-ventilator hospital-acquired pneumonia (NV-HAP), which significantly contributes to sepsis, mortality, prolonged hospitalization and increased healthcare costs. Moreover, the condition impacts negatively on a hospital’s reputation and finances, highlighting the importance of identifying effective preventative strategies.
One alarming report from the National Organization to Prevent Hospital-Acquired Pneumonia (NOHAP) suggests that 1 in every 100 hospitalized patients could contract NV-HAP, with an incidence rate of 2.63 per 1,000 patient days over a 5-year study period from 2015 to 2019. These figures suggest that NV-HAP is more than four times as prevalent as many other HAIs. Significant aspects of NV-HAP impacting hospital metrics include its contribution to sepsis and mortality rates. Statistics indicate a sepsis rate of 36.3% among patients with NV-HAP, overburdening healthcare facilities with the need for further care. In addition, mortality rates among patients with NV-HAP observations were found to be 0.32 per 1,000 patient days.
The length of hospital stay (LOS) is also prolonged by NV-HAP – by up to 15 days – creating financial challenges for hospitals. The estimated cost of care for patients with NV-HAP stands between $28,000-$40,000, potentially resulting in financial losses for hospitals and thereby emphasizing the need for preventative measures.
Findings from a recent pilot study have shown significant improvements in sepsis and mortality rates following the implementation of an oral care bundle, bolstering the case for prioritizing NV-HAP prevention. As such, quantifying the full impact of NV-HAP on their facilities can enable hospitals to decide on priority HAC/HAI reduction goals, ultimately enhancing patient outcomes while reducing healthcare burden.