Hospital tackles pneumonia threat Strategy includes screening, vaccinations

Dariush Shafa

Jul. 7, 2008 (McClatchy-Tribune Regional News delivered by Newstex) -- While some may associate pneumonia with colder weather, it's actually a year-round threat -- and caregivers at Owensboro Medical Health System are looking at ways to reduce the risk for patients admitted to the hospital.

OMHS is placing an emphasis on improving screening protocols and making people aware of the need for a pneumonia vaccination, officials said last week.

Pneumonia is an inflammation of the lungs caused by infection, which results in the lungs filling with fluid. It can have a number of different causes, especially bacterial infection.

In 2005, there were 1.4 million hospitalizations for pneumonia. Local health care officials say that by fighting pneumonia proactively, everyone wins because patients are healthier and the cost to the health care system is lowered.

"It's a huge expense nationally. It's a real issue in our health care system," said Dr. Greg Jacobs, a physician in the emergency department at OMHS. "It's not an obscure thing that we only see rarely. It's a big phenomenon."

It's also a debilitating and often deadly problem. According to the 2005 statistics provided by the National Center for Health Statistics, the average hospital stay for a patient with pneumonia was 5.3 days. The number of deaths from pneumonia in 2004 was 58,564, and about 5.4 percent of all deaths of patients in hospitals were due to pneumonia.

To that end, doctors and others are looking for ways to keep pneumonia out of the hospital before it can even get into patients. Doctors have used this philosophy successfully with many diseases from polio to smallpox. By promoting the pneumonia vaccine, especially for people over age 65, they hope to lessen the problem.

"As we've learned with all kinds of vaccines, anything you can do to reduce its instance or severity is helpful," Jacobs said of the advent (NYSE:AGC) of widespread use of vaccination. "It's made a huge impact on the quality of people's lives and the cost to our society."

The use of the vaccine is all the more important with the elderly because they are less able to fight off the disease. Children under age 2 and people with certain immune system-compromising diseases and conditions are also at risk.

"For the elderly, they're already sick and have so many issues, and it makes their hospital stay longer and much more difficult," Jacobs said.

At OMHS, administrators are examining certain procedures and looking at ways to keep people admitted to the hospital from returning there with pneumonia. By screening every adult patient to see if he's had the pneumonia vaccine, identifying high-risk patients and those in need of the vaccine and then getting it to them, the hope is that cases of pneumonia can be lowered.

The NCHS statistics show that the pneumonia vaccination rate for people under age 65, which has a goal of 90 percent or better, is only at 56 percent as of 2005. The vaccine, which cannot give a person pneumonia and covers 23 different pneumonia-causing bacteria, is covered by Medicare for those over 65 and is generally only needed once, though Medicare covers one vaccination shot every five years.

Joni Sims, medical-surgical director at OMHS, said the hope is to improve the system within the hospital to the point where it meets goals set by the Centers for Disease Control and Prevention, which set the vaccination bar at 90 percent.

"We're really good at initiating the screening, but we need a little work on our screening procedures," Sims said.

To change that, the screening form that goes in patient charts is being redone and medical staff members are getting one-on-one feedback on how they are conducting the screenings.

Eventually, the hospital also would like to see the addition of a protocol where nurses could screen patients and then vaccinate those who meet certain criteria.

That protocol, however, would have to be approved by the doctors in the hospital, and that is unlikely to happen until the screening procedures are secured and down pat, officials said.

"If they feel that we're accurately screening the patients, I think we can make it work," Sims said. "We screen them on admission. Our goal is to vaccinate them on discharge (so they don't have to return because of pneumonia)."

Jean Byrd, director of extended care at OMHS, said along with improving screening and vaccination protocols, another goal is to raise awareness of the vaccine.

"They need to be made aware that this can save their life," Byrd said.

Newstex ID: KRTB-0152-26478754