Postoperative Pneumonia Prevention Checklist Improves Provider Compliance and Patient Awareness of Previously Established Reduction Protocol

Authors

DOI:

https://doi.org/10.33940/med/2022.6.6

Keywords:

checklist, postoperative pneumonia, quality improvement, compliance

Abstract

Visual Abstract

Background: Postoperative pneumonia (PoPNA) is a highly prevalent complication in patients. Despite a previously successful protocol, this institution has become a high outlier on national metrics for PoPNA in the last four years.

Methods: Between October 2020 and May 2021, patients were surveyed to measure 10 initiatives which have shown previous success. A provider-driven 10-item checklist was implemented and patients were resurveyed.

Results: 135 patients were included: 96 pre-checklist and 39 post-checklist. Improvement was seen in all 10 categories. This included provider-driven initiatives, such as patient oral care, ambulation, frequency of patient being in chair, having incentive spirometer (IS) within reach, having information booklet within reach, and the patient’s ability to perform IS correctly, as well as patient awareness initiatives, including importance of oral care, cough and deep breathing, ambulation, and IS use.

Conclusions: Implementation of a simple checklist can improve awareness and compliance with previously successful established protocols.

Author Biographies

Ryan Lamm, MD, Thomas Jefferson University Hospital, Department of Surgery

Ryan Lamm (Ryan.Lamm@jefferson.edu) is a general surgery resident at Thomas Jefferson University Hospital (TJUH) in Philadelphia. He participated in this project as a part of his research year. He performed literature review, project planning, methodology, statistical analysis, manuscript writing, and editing.

Brandon A. Creisher, BS, Thomas Jefferson University Hospital, Department of Surgery

Brandon Creisher is a medical student at TJUH in Philadelphia. He performed literature review, data collection, and manuscript editing.

John G. Curran, BS, Thomas Jefferson University Hospital, Department of Surgery

John Curran is a medical student at TJUH in Philadelphia. He performed literature review, data collection, and manuscript editing.

Emily Foecke Munden, MA, Thomas Jefferson University Hospital, Department of Surgery

Emily Foecke Munden is a medical student at TJUH in Philadelphia. She performed literature review, data collection, and manuscript editing.

John E. Williamson III, BS, Thomas Jefferson University Hospital, Department of Surgery

John E. Williamson III is a medical student at TJUH in Philadelphia. He performed literature review, data collection, and manuscript editing.

Christine Schleider, BSN, Thomas Jefferson University Hospital, Department of Surgery

Christine Schleider is a clinical nurse reviewer in the Department of Surgery at TJUH in Philadelphia. She performed project planning, methodology, and manuscript editing.

Kathleen Shindle, BSN, Thomas Jefferson University Hospital, Department of Surgery

Kathleen Shindle is a clinical nurse reviewer in the Department of Surgery at TJUH in Philadelphia. She performed project planning, methodology, and manuscript editing.

Scott Cowan, MD, Thomas Jefferson University Hospital, Department of Surgery

Scott Cowan is an associate professor in the Department of Surgery at TJUH in Philadelphia and is the enterprise chair of Safety and Quality. He performed project planning, methodology, and manuscript editing.

Harish Lavu, MD, Thomas Jefferson University Hospital, Department of Surgery

Harish Lavu is a professor in the Department of Surgery at TJUH in Philadelphia and serves as a co-vice chair of Quality and Safety in the Department. He performed project planning and manuscript editing.

Caitlyn Costanzo, MD, Thomas Jefferson University Hospital, Department of Surgery

Caitlyn Costanzo is an assistant professor in the Department of Surgery at TJUH in Philadelphia and serves as a co-vice chair of Quality and Safety in the Department. She performed project planning and manuscript editing.

References

Dimick JB, et al. Hospital Costs Associated With Surgical Complications: A Report From the Private-Sector National Surgical Quality Improvement Program. J Am Coll Surg. 2004;199(4):531-7.

Khan NA, et al. Association of Postoperative Complications With Hospital Costs and Length of Stay in a Tertiary Care Center. J Gen Intern Med. 2006;21(2):177-180.

Cassidy MR, et al. I COUGH: Reducing Postoperative Pulmonary Complications With a Multidisciplinary Patient Care Program. JAMA Surg. 2013;148(8):740-745.

Khuri SF, Daley J, Henderson WG. The Comparative Assessment and Improvement of Quality of Surgical Care in the Department of Veterans Affairs. Arch Surg. 2002;137(1):20-27.

Conley, DM, et al. Effective Surgical Safety Checklist Implementation. J Am Coll Surg. 2011;212(5):873-879.

Galvin, G, et al. Availability of Safe Childbirth Supplies in 284 Facilities in Uttar Pradesh, India. Matern Child Health J, 2019;23(2):240-249.

Ramsay G, et al. Reducing Surgical Mortality in Scotland by Use of the WHO Surgical Safety Checklist. Br J Surg. 2019;106(8)1005-1011.

Urbach DR, et al. Is WHO’s Surgical Safety Checklist Being Hyped? BMJ. 2019;366:l4700.

Berry WR, et al. Scaling Safety: The South Carolina Surgical Safety Checklist Experience. Health Aff (Millwood). 2018;37(11):1779-1786.

Alexander JA, Hearld LR. What Can We Learn From Quality Improvement Research? A Critical Review of Research Methods. Med Care Res Rev. 2009;66(3):235-271.

Investigators, W.G.f.t.C.-I. and B.R.i.I.C. Network, Effect of a Quality Improvement Intervention With Daily Round Checklists, Goal Setting, and Clinician Prompting on Mortality of Critically Ill Patients: A Randomized Clinical Trial. JAMA. 2016;315(14):1480-1490.

Snyder C, Anderson G. Do Quality Improvement Organizations Improve the Quality of Hospital Care for Medicare Beneficiaries? JAMA. 2005;293(23):2900-2907.

Bowman CC, et al. Measuring Persistence of Implementation: QUERI Series. Implement Sci. 2008;3(1):1-13.

Dückers ML, et al. Exploring the Black Box of Quality Improvement Collaboratives: Modelling Relations Between Conditions, Applied Changes and Outcomes. Implement Sci. 2009;4(1):1-12.

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Published

2022-06-17

How to Cite

Lamm, R., Creisher, B. A., Curran, J. G., Foecke Munden, E., Williamson III, J. E., Schleider, C., Shindle, K., Cowan, S., Lavu, H., & Costanzo, C. (2022). Postoperative Pneumonia Prevention Checklist Improves Provider Compliance and Patient Awareness of Previously Established Reduction Protocol. Patient Safety, 4(2), 62–69. https://doi.org/10.33940/med/2022.6.6

Issue

Vol. 4 No. 2 (2022): Patient Safety-June 2022

Section

Original Research and Articles
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