Pneumonia is the second most common cause of infection in nursing facilities. A seasonal increase in pneumonia occurs due to influenza and unfortunately, many nursing home residents do not survive.
The most common pneumonia pathogens in the nursing facility are Streptococcus pneumoniae, Haemophilus influenae and Klebsiella pneumoniae. Residents at risk for pneumonia are those with decreased clearance of bacteria from the airway, altered throat flora, poor functional status (such as limited mobility), presence of a feeding tube, swallowing difficulties or history of aspiration and inadequate oral care.
Strategies to help reduce the risk of infection that can lead to pneumonia.
- Inadequate oral care can cause the germs in the mouth to multiply rapidly and trickle down in the lungs during sleep. These germs can then cause pneumonia. Removing the biofilm from the teeth with regular brushing can help prevent pneumonia.
- Ensure adequate nutrition and hydration, elevate the head of the bed 3 – 45 degrees during tube feedings and for at least 1 hour to decrease aspiration, perform hand hygiene after contact with respiratory secretions, use gloves for suctioning and cleaning respiratory equipment, provide twice daily oral care to prevent bacteria from accumulating and reduce the risk of pneumonia if aspiration occurs.
- The facility’s role in respiratory infection prevention is to ensure policies reflect current recommended practices, ensure staff competency upon hire and at least annually, establish an adherence monitoring program for measuring prevention care practices, and prove feedback to frontline staff and leaders.
- Prevent pneumonia through vaccination. It is important to promote pneumococcal vaccines, annual influenza vaccines and stay up- to-date with COVID-19 vaccination for nursing home residents and staff.
Great Plains QIN Additional Resources:
Vaccinations, Quality Measures and Infection Prevention
- Connecting the Dots – Antibiotic Stewardship, Immunization, Sepsis
- Nursing Home Vaccination Change Package
- #GetVaccinated Long-Term Care Provider Toolkit
- Influenza Quality Measure MDS Coding Tip Sheet
- Pneumococcal Quality Measure MDS Coding Tips
- Vaccination Quality Measure Checklist
- Electronic Vaccination Log – Excel File
- Examples of Available Metrics for Risk Calculation of Respiratory Illness [fillable form)
- Infection Prevention Orientation Checklist
Focus for Health August 2023 Series: Looking at Immunizations Through a Different Lens
Angle on Equity | Recording
Snapshot of Data and Immunization Information Systems | Recording
Zoom in on Vaccine Hesitancy | Recording
Framing Your Delivery of Vaccinations | Recording
Listen to Our Podcast – Q-Tips For Your Ears