Adhering to The Joint Commission's pneumonia core measure
Karen Michaels MS, PharmD
LeighAnn Sidone MSN, RN, OCN, CENP

February 2014 
Volume 44  Number 2
Pages 20 - 22
  PDF Version Available!

A LEADING CAUSE of illness and death in the United States and worldwide, Streptococcus pneumoniae can cause pneumonia, bacteremia, and meningitis.1 Those at higher risk of contracting disease from this bacterium are the very young, those with underlying chronic diseases, and adults age 65 and over. S. pneumoniae infection accounts for nearly two-thirds of lethal pneumonia cases annually; more than 125,000 patients with streptococcal pneumonia require hospitalization each year.1,2 Mortality from S. pneumoniae bacteremia and meningitis is 1 in 5 and 3 in 10, respectively.1,2A major preventive measure for this serious infection is the pneumococcal vaccine. Consequently, The Joint Commission has identified pneumonia as a hospital core measure with pneumococcal vaccination as a criterion.3The Joint Commission criteria for vaccination were initially limited to patients age 65 and older, but in January 2013, indications for the vaccine were expanded to include patients ages 5 to 64 with certain chronic illnesses, such as HIV, asplenia, end-stage renal disease, heart disease, and diabetes.2,4 This article describes Suburban Hospital's (SH's) successful adherence to The Joint Commission's pneumonia core measure.The process for giving patients the pneumococcal vaccine at SH, part of Johns Hopkins Medicine, began in 2004 with the nursing staff screening for eligible patients. The medical staff approved a nurse-driven protocol giving nurses the authority to implement standing orders for vaccination based on eligibility requirements. If a patient met the screening criteria, a nurse would administer the vaccine on the day of discharge.The compliance rate with this process was only 47%. This was far below SH's goal for pneumococcal vaccination, which was based on guidelines from the Delmarva Foundation.The Delmarva Foundation is a quality improvement organization whose mission is to improve health services and programs.5 The foundation's goal for pneumonia vaccination is 90%. SH has

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