Specialist pneumonia intervention nurse service improves pneumonia care and outcome

Background A specialist pneumonia intervention nursing (SPIN) service was set up across a single National Health Service Trust in an effort to improve clinical outcomes. A quality improvement evaluation was performed to assess the outcomes associated with implementing the service before (2011–2013)...

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Main Authors: Matthew Richardson, Robert C Free, Pranabashis Haldar, Gerrit Woltmann, Camilla Pillay, Kayleigh Hawkes, Julie Skeemer, Rebecca Broughton
Format: Article
Language:English
Published: BMJ Publishing Group 2021-01-01
Series:BMJ Open Respiratory Research
Online Access:https://bmjopenrespres.bmj.com/content/8/1/e000863.full
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author Matthew Richardson
Robert C Free
Pranabashis Haldar
Gerrit Woltmann
Camilla Pillay
Kayleigh Hawkes
Julie Skeemer
Rebecca Broughton
author_facet Matthew Richardson
Robert C Free
Pranabashis Haldar
Gerrit Woltmann
Camilla Pillay
Kayleigh Hawkes
Julie Skeemer
Rebecca Broughton
author_sort Matthew Richardson
collection DOAJ
description Background A specialist pneumonia intervention nursing (SPIN) service was set up across a single National Health Service Trust in an effort to improve clinical outcomes. A quality improvement evaluation was performed to assess the outcomes associated with implementing the service before (2011–2013) and after (2014–2016) service implementation.Results The SPIN service reviewed 38% of community-acquired pneumonia (CAP) admissions in 2014–2016. 82% of these admissions received antibiotic treatment in <4 hours (68.5% in the national audit). Compared with the pre-SPIN period, there was a significant reduction in both 30-day (OR=0.77 (0.70–0.85), p<0.0001) and in-hospital (OR=0.66 (0.60–0.73), p<0.0001) mortality after service implementation, with a review by the service showing the largest independent 30-day mortality benefit (HR=0.60 (0.53–0.67), p<0.0001). There was no change in length of stay (median 6 days).Conclusion Implementation of a SPIN service improved adherence to BTS guidelines and achieved significant reductions in CAP-associated mortality. This enhanced model of care is low cost, highly effective and readily adoptable in secondary care.
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spelling doaj-art-e2c1c7242c974a4e912f338a4ce8fd622025-08-20T01:53:20ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392021-01-018110.1136/bmjresp-2020-000863Specialist pneumonia intervention nurse service improves pneumonia care and outcomeMatthew Richardson0Robert C Free1Pranabashis Haldar2Gerrit Woltmann3Camilla Pillay4Kayleigh Hawkes5Julie Skeemer6Rebecca Broughton71 Department of Respiratory Sciences, University of Leicester, Leicester, UK3 Department of Respiratory Sciences, University of Leicester, Leicester, UKNIHR Leicester Biomedical Research Centre, Department of Respiratory Sciences, University of Leicester, Leicester, UKDepartment of Respiratory Sciences, University of Leicester, Leicester, UKRenal Unit, King`s College Hospital, London, UKRespiratory Medicine Department, Glenfield Hospital, Leicester, UKRespiratory Medicine Department, Glenfield Hospital, Leicester, UKCorporate Medical and Nursing, University Hospitals of Leicester NHS Trust, Leicester, UKBackground A specialist pneumonia intervention nursing (SPIN) service was set up across a single National Health Service Trust in an effort to improve clinical outcomes. A quality improvement evaluation was performed to assess the outcomes associated with implementing the service before (2011–2013) and after (2014–2016) service implementation.Results The SPIN service reviewed 38% of community-acquired pneumonia (CAP) admissions in 2014–2016. 82% of these admissions received antibiotic treatment in <4 hours (68.5% in the national audit). Compared with the pre-SPIN period, there was a significant reduction in both 30-day (OR=0.77 (0.70–0.85), p<0.0001) and in-hospital (OR=0.66 (0.60–0.73), p<0.0001) mortality after service implementation, with a review by the service showing the largest independent 30-day mortality benefit (HR=0.60 (0.53–0.67), p<0.0001). There was no change in length of stay (median 6 days).Conclusion Implementation of a SPIN service improved adherence to BTS guidelines and achieved significant reductions in CAP-associated mortality. This enhanced model of care is low cost, highly effective and readily adoptable in secondary care.https://bmjopenrespres.bmj.com/content/8/1/e000863.full
spellingShingle Matthew Richardson
Robert C Free
Pranabashis Haldar
Gerrit Woltmann
Camilla Pillay
Kayleigh Hawkes
Julie Skeemer
Rebecca Broughton
Specialist pneumonia intervention nurse service improves pneumonia care and outcome
BMJ Open Respiratory Research
title Specialist pneumonia intervention nurse service improves pneumonia care and outcome
title_full Specialist pneumonia intervention nurse service improves pneumonia care and outcome
title_fullStr Specialist pneumonia intervention nurse service improves pneumonia care and outcome
title_full_unstemmed Specialist pneumonia intervention nurse service improves pneumonia care and outcome
title_short Specialist pneumonia intervention nurse service improves pneumonia care and outcome
title_sort specialist pneumonia intervention nurse service improves pneumonia care and outcome
url https://bmjopenrespres.bmj.com/content/8/1/e000863.full
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