Quality Care for Pneumonia
Patients experiencing pneumonia should expect to receive
the following standard treatments:
- Blood culture taken prior to antibiotic
- Antibiotic within eight hours
- Oxygenation assessment within 24 hours
- Advice for smokers on how to stop smoking
The Centers for Medicare & Medicaid
Services and the Joint Commission for the Accreditation
of Healthcare Organizations have determined that the treatments
listed above are indicators of quality care for pneumonia.
Look for and expect these treatments at the hospital.
When you go the hospital or emergency room for pneumonia,
a nurse or physician should give you prompt attention that
includes a physical exam. In order to start your treatment
as quickly as possible, several steps need to be done. Your
doctor will need to examine you, order tests, make a diagnosis
of pneumonia, and choose the best antibiotic for your condition.
- Blood Culture
A blood culture should be done before you receive an antibiotic.
Blood cultures are tests performed on samples of blood
to check for infection. They can also detect the bacteria
or other germs causing the infection to help determine
the best course of treatment for you. In patients with
pneumonia, the infection in the lungs can spread to the
blood. When this happens, the patient's condition can
worsen if not detected and treated early.
What to expect: A lab technician or
nurse will take two blood samples from two different
locations for accuracy. If you are given antibiotics
before blood samples have been taken, ask your doctor
or nurse why blood cultures were not obtained. There
may be a good reason, such as the need to get the antibiotics
started right away, or if you were already on antibiotics
before coming to the hospital.
Patients with pneumonia usually take an antibiotic
to get rid of the infection. An antibiotic is a medication
designed to kill the bacteria or other germs that causes
pneumonia. Viruses can also cause pneumonia, but they are
rarely susceptible to antibiotics. Studies show that seniors
who receive antibiotics within eight hours of hospital
arrival have an increased chance of survival.
What to expect: After an antibiotic has
been ordered, you should receive the first dose quickly.
If you are in the emergency room, the emergency room might
have a supply of antibiotics on hand, so the doctor would
not have to wait for an order to be processed at the hospital
Hospitalized patients may receive antibiotics through the
veins (intravenously), but antibiotics can also be taken
by mouth (orally). Sometimes, you may stay in the hospital
receiving intravenous antibiotics for two or three
days, then go home to recover on oral medicine.
Note that after the results of the blood culture are returned,
the doctor may change the drugs you are given in order
to fight the infection better.
- Oxygenation assessment
All pneumonia patients should have their blood
oxygen level checked within eight hours of admission to
the hospital. Measuring the oxygen level in the blood of
patients with pneumonia helps the doctor determine the
severity of the pneumonia, the need for extra oxygen, and
whether the patient should be admitted to the hospital.
Studies show that providing extra oxygen to certain people
with pneumonia who have low blood oxygen levels can decrease
risk of death. Pneumonia weakens the lungs’ ability
to exchange oxygen for carbon dioxide, causing the body
to receive too little oxygen. This lack of oxygen can kill
tissue as well as making it difficult to breathe. If left
untreated, it may lead to death.
You also may receive treatments to make you more comfortable,
such as oxygen and medicine for coughing and chest discomfort.
Oxygen may be given through a small tube in your nose,
or a mask over your nose and mouth.
What to expect: You should receive either
a blood test called an arterial blood gas or a pulse-oximetry,
which detects oxygen through a sensor placed on your finger
or ear lobe. If you have rapid, gasping breaths, the hospital
should test your blood immediately because your body may
not be receiving the oxygen it needs.
If you have a chronic lung disease, such as emphysema and
chronic obstructive pulmonary disease, you may not receive
extra oxygen. In this case, ask your doctor if you should
- Advice to stop smoking
Smokers who stop smoking can improve the way their
lungs work. You can ask a doctor or nurse for information
about quitting and whether there are classes or programs
you can attend. You may want to ask them about medications
that will help you quit and if the medications would be
appropriate for you.
What to expect: If you smoke, you should receive
counseling during a hospital stay on how to quit smoking.
The hospital staff may tell you about classes, group
sessions, reading materials, or medications available
to help you.