Gur Levy1, Mario Perez2, Benito Rodríguez3, Ana Hernández Voth3, Jorge Perez4, Martin Gnoni4, Robert Kelley4, Timothy Wiemken4, Julio Ramirez5. 1. Servicio de Neumología, Hospital Universitario de Caracas, Caracas, Venezuela. 2. Servicio de Neumología, Hospital Universitario de los Andes, Mérida, Venezuela. 3. Servicio de Medicina Interna, Hospital IVSS Dr. Domingo Guzmán L. Barcelona, Estado Anzoátegui, Venezuela. 4. División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos. 5. División de Enfermedades Infecciosas, Universidad de Louisville, Kentucky, Estados Unidos. Electronic address: julio.ramirez@louisville.edu.
Abstract
INTRODUCTION: The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP. METHODS: In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8 Venezuelan's centers. The care of the patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (>90%), intermediate (60% to 90%), or low (<60%). RESULTS: A total of 454 patients with CAP were enrolled. The empiric treatment administered within 8 hours of the patient arrival to the hospital was good (96%), but the rest of the indicators showed a low level of adherence (<60%). CONCLUSION: We can say that there are many areas in the management of CAP in Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement process the first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela.
INTRODUCTION: The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP. METHODS: In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8 Venezuelan's centers. The care of the patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (>90%), intermediate (60% to 90%), or low (<60%). RESULTS: A total of 454 patients with CAP were enrolled. The empiric treatment administered within 8 hours of the patient arrival to the hospital was good (96%), but the rest of the indicators showed a low level of adherence (<60%). CONCLUSION: We can say that there are many areas in the management of CAP in Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement process the first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela.
Keywords:
Clinical practice guidelines; Guías de práctica cínica; Health care quality indicators; Indicadores de calidad de la atención de salud; Neumonía; Pneumonia
Authors: M A Fernandez-Sierra; M T Rueda-Domingo; M M Rodriguez-Del-Aguila; M J Perez-Lozano; L Force; T Fernandez-Villa; J Astray; M Egurrola; J Castilla; F Sanz; D Toledo; A Dominguez Journal: Epidemiol Infect Date: 2018-08-02 Impact factor: 4.434