STUDY OF CURRENT MANAGEMENT OF COMMUNITY ACQUIRED PNEUMONIA AND STRATEGIES FOR IMPROVEMENT

Abstract

Objective: To see that the patients admitted with community acquired pneumonia (CAP) are managed in accordance with British Thoracic society recommendations and guidelines.

Material and Methods: All patients admitted with Community-Acquired Pneumonia in medical wards admitted in large district general hospital setting in UK, were audited. The study period was between September and October 2002. Permission for the study was taken from the local hospital trust audit department.

Results: Seventy one sets of notes were reviewed leaving 38 patients appropriate for inclusion into the study. The findings observed in the record revealed that, Respiratory rate was not recorded in 36.8% (n=14) patients, level of confusion not recorded in 47.4% (n=18), Blood cultures not sent in 42.1% (n=16) patients, sputum not sent for culture in 47.4% (n=18) cases. Inappropriate antibiotics used 18.4% (n=7), reatment time of senior review not documented in 36.8% (n=14), radiographic findings not documented in 13% (n=5) cases. No follow up arrangements were made in 13.2% (n=5). Average time of senor review was 6 hours and average time of antibiotic given after admission was 2 hours.

Conclusion: This audit shows that even in a developed country with well-established guidelines for management of different diseases, guidelines for management of community-acquired pneumonia are not strictly adhered to. More efforts need to be made for dissemination and implementation of these guidelines.