In fact, according to American Lung Association (2007), approximately five (5) million pneumonia cases occur annually; the cause of almost 55 million days (Kochanek & Smith, 2002) of restricted activity, as well as 1.3 million hospitalizations each year. Furthermore, inpatient treatment for pneumonia (Niederman, 1998) amounts to more than $7.5 billion annually. Roark (2003) added that this disease is the second most widespread nosocomial infection. As of 2003, the annual incidence reached up to five to 10 cases in every 1,000 admissions and can further lead into mechanical ventilation for 48 hours or more, duration of hospital stay, worsening of underlying illness as well as presence of co-morbidities. Previous antibiotic use prior to the onset of nosocomial pneumonia elevates the likelihood of infection, particularly with those virulent organisms like Acinetobacter sp. and Pseudomonas aeruginosa.
Conventional preventive measures against nosocomial pneumonia take account of the patients' decreasing aspiration, proper disinfection/sterilization of devices used in respiratory-therapy, use of effective vaccines against particular infections, avoiding cross contamination via hands of personnel and health education among patients and hospital staff. New measures under investigation involve reducing oropharyngeal and gastric colonization.
Collaboration amongPneumonia as Core Performance Measure
Collaboration among variety of stakeholders is an integral process in the measurement of Pneumonia Core Performance. The Joint Commission (2009) in early 1999, was able to solicit inputs from different health care provider organizations, clinical professionals, health care consumers, state hospital associations, and convened the Pneumonia Advisory Panel to discuss the areas for core measures for hospitals.
The Joint Commission is a distinguished and awarded international leader, able and has been proven to effectively carry out the identification process, test and denote standardized performance measures. It has been involved in performance measurement research, development activities, and ongoing, established successful, as well as collaborative relationships with key performance measurement sets. The agency has set the initial pneumonia measure that exists in five (5) measures namely: Oxygenation Assessment, Blood Cultures, Pneumococcal Screening and/or Vaccination, Smoking Cessation Advice/Counseling, and also the Antibiotic
Timing. Later, two additional measures were implemented and these are the: Antibiotic Selection and Influenza Vaccination.
All together, the Joint Commission function with the CMS or Centers for Medicare & Medicaid Services on pneumonia measures with the intention of common to both organizations. CMS with the Joint Commission worked together in order to align the measure specifications which are to be used in the 7th Scope of Work and also for Joint Commission accredited hospitals. On July 1, 2002, hospitals began collecting the preliminary five (5) pneumonia measures intended for patient discharges.
Core Measures monitor a range of evidence-based, the scientifically researched standards of care that have been shown to effect in improved clinical outcomes for patients. The establishment of Core Measures in 2000 by the Center for Medicare and Medicaid (CMS) has started to release public statements about hospital core measure findings in