A postoperative pneumonia prevention program for patients in the surgical ward nearly halved the incidence of the condition, California researchers have found.

The program, at the VA Palo Alto Health Care System, emphasized ongoing education for nurses, pneumonia prevention, coughing and deep-breathing exercises with an incentive spirometer, twice-daily oral hygiene with chlorhexidine, walking and sitting up to eat.

The study included patients who were not on a mechanical ventilator from 2008 to 2012. During this time, there were 18 cases of postoperative pneumonia among 4,099 at-risk patients, for a case rate of 0.44%. That marked a 44% decrease from the hospital’s preintervention rate of 0.78%, according to the researchers. Pneumonia rates in all years were lower than the preintervention rate (0.25%, 0.50%, 0.58%, 0.68% and 0.13% in 2008 to 2012, respectively).

“The standardized pneumonia prevention program achieved substantial and sustained reduction in postoperative pneumonia incidence on our surgical ward; its wider adoption could improve postoperative outcomes and reduce overall health care costs,” wrote the authors, who published their findings in JAMA Surgery (2014 Jul 23 [Epub ahead of print]).

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