Original scientific paper
https://doi.org/10.22514/SV132.112017.6
Influence of the adequacy of data collection, during two years, in the management of communityacquired pneumonia in emergency departments
RAFAEL PERELLÓ
; Área de Urgencias, Hospital Clínic, Barcelona, Spain
P. RIMBAU
C. GOMEZ VAQUERO
N. SAUBÍ
A. JUAN PASTOR
Abstract
Objective. The aim of this study was to
analyze whether structured data collection
of patients with community-acquired
pneumonia (CAP) in the Emergency Department
(ED) improves compliance with
clinical guidelines regarding inpatient and
outpatient treatment and prescription of
antibiotics at discharge.
Material and methods. We performed a
quasi experimental, multicenter, pre/postintervention
study. The intervention consisted
of basic training for the participating
physicians and the incorporation of a
data collection sheet in the clinical history
chart, including the information necessary
for adequate decision making regarding
patient admission and treatment,
in the case of discharge. We analyzed the
adequacy of the final destination of patients
classified as Fine I-II and antibiotic
treatment in patients receiving outpatient
treatment, with each participating physician
including 8 consecutive patients (4
pre-intervention and 4 post-intervention).
Results. A total of 738 patients were included:
378 pre-intervention and 360
post-intervention. In the pre-intervention
group, Fine V was more frequent and patients
were older, had more ischemic heart
disease, active neoplasms and fewer risk
factors for atypical pneumonia. Of the
patients with Fine I-II, 23.7% were inadequately
admitted and 19.6% of those
discharged received treatment not recommended
by guidelines. No differences
were observed in the target variables between
the two groups.
Conclusion. The adequacy of the decision
to admit patients with Fine I-II CAP and
outpatient antibiotic treatment can be improved
in the ED. Structured data collection
does not improve patient outcome.
Keywords
community-acquired pneumonia; emergency department; antibiotic treatment; adequacy of admission
Hrčak ID:
190592
URI
Publication date:
12.12.2017.
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