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Nurse-led team improving outcomes for pneumonia patients

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A new nurse-led respiratory infections team has reduced both hospital stays for patients with pneumonia and unnecessary antibiotic use, according to latest data.

The team is delivering targeted and effective diagnosis and treatment for patients with community-acquired pneumonia (CAP), leading to reduced hospital stays for the condition, according to a study.

“We hope other NHS trusts will pick it up and introduce similar versions”

Tom Bewick

It was set up at Derby Teaching Hospitals NHS Foundation Trust in order to try and reduce the use of broad spectrum antibiotics for patients with CAP, in favour of targeted narrow spectrum antibiotics.

As well as improving antibiotics use, researchers revealed data at a conference showing that the new team had helped reduce the median length of stay by two days for patients admitted with CAP.

One year on from its introduction, the full review of data from 301 patients was “encouraging”, said the researchers today at the British Thoracic Society’s 2017 Winter Meeting in London.

They said identification of the organism causing pneumonia increased to 22.9%, up from 4.9% the year prior, leading to many more patients having targeted antibiotic strategies.

Early supported discharge was found to be appropriate for 30% of patients with low severity pneumonia, with no increase in hospital readmissions or mortality, they added.

Consisting of one consultant, one specialist nurse and one antimicrobial pharmacist, the team focused on three core areas with all patients admitted to hospital with CAP.

  • For those patients with low severity pneumonia, the team facilitated outpatient management with telephone support and follow up, providing many patients with the comfort of being at home, while reducing length of stay in hospital, and freeing up hospital beds
  • Performing point-of-care tests to identify as early as possible the infecting organism the patient is suffering from, enabling the provision of the correct targeted antibiotic, rather than providing broad spectrum antibiotics empirically, as previously carried out
  • Promoting adherence to the British Thoracic Society’s CAP care bundle, such as patients receiving an X-ray within four hours and increasing diagnostic accuracy

The trust has also recently received a grant from NHS England to expand the service, so the team now has three nurses to cover 365 days a year, offering follow-up clinics, and supporting education and good practice.

Dr Tom Bewick, the respiratory consultant behind the initiative, said: “This new team has helped deliver better care for patients by reducing the amount of time spent in hospital, reducing unnecessary antibiotic use and improving diagnostic accuracy.

“This is a totally new service which improves care, is cost-effective and helps with the fight against antibiotic resistance,” he said. “We hope other NHS trusts will pick it up and introduce similar versions.”

He added: “As we continue to face severe pressures on finding beds during winter, this is one way to free up NHS resources for those in most need.”

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