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Updated: Sep 4, 2026
13:27
Osteopathic Manipulative Treatment as a Useful Adjunctive Tool for Pneumonia
Published on: May 6, 2014
介護の質,プロセス,および肺炎の高齢患者における結果
T P Meehan1, M J Fine, H M Krumholz
1Connecticut Peer Review Organization, Middletown, USA. ctpro.tmeehan@sdps.org
JAMA
|December 24, 1997
まとめ
高齢者の肺炎患者に対する抗生物質の適時投与と血液培養の採取は,生存率を大幅に改善します. 州によって大きな差異があることから,病院での医療の質を向上させ,死亡率を低減するチャンスが浮き彫りにされています.
科学分野:
- ゲロントロジーはゲロントロジーの学科です.
- 感染症 感染症は感染症です.
- 医療の質の向上 医療の質の向上
背景:
- 肺炎は高齢者の入院と死亡の主な原因です.
- 肺炎のアウトカムに対するケアプロセスの影響に関して不確実性が存在し,品質改善の努力を複雑にします.
研究 の 目的:
- 肺炎で入院したメディケア患者の医療の質を評価する.
- 特定のケアプロセスの遵守が30日間の死亡率の減少と関連しているかどうかを判断する.
主な方法:
- 医療記録のレビューを含む多センターの遡及的なコホート研究.
- 分析対象は,米国の急性ケア病院で65歳以上の患者14,069人,3,555人の患者でした.
- 評価された主なプロセス: 適時抗生物質投与, 抗生物質前血液培養, 適時酸素化評価.
主要な成果:
- 8時間以内に抗生物質を投与した患者は75.5%で,24時間以内に採血した患者は68.7%でした.
- 30日間の死亡率の低下は,8時間以内に抗生物質 (OR 0.85) と24時間以内に血液培養 (OR 0.90) と関連していました.
- これらの主要なプロセスのパフォーマンスの州レベルでの大きな変動が観察されました.
結論:
- 8時間以内に抗生物質を投与し,24時間以内に血液培養を採取することは,高齢の肺炎患者の生存率の向上と関連しています.
- 各州間の介護の提供における大きな格差は,病院の介護と患者のアウトカムを改善するための実質的な機会を示しています.
関連する概念動画
01:30Pneumonia I: Introduction
Pneumonia is an acute respiratory infection that targets the lungs, specifically the alveoli. These tiny air sacs, essential for oxygen exchange, become engorged with pus and fluid, severely hindering breathing, decreasing oxygen absorption, and causing significant pain and discomfort during respiration.
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:29Pneumonia II: Pathophysiology
The pathophysiology of pneumonia involves the following steps:
01:30Pneumonia III: Complications and Assessment
Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
01:28Pneumonia IV: Management
The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:30Pneumonia V: Nursing management and Prevention
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed.
01:29Pneumonia I: Introduction
Pneumonia is an infection of the lower respiratory tract that leads to inflammation of the lung parenchyma, often resulting in the accumulation of inflammatory exudate in the alveoli and airways. Unlike the watery, low-protein fluid exudate in pulmonary edema, the exudate in this case is a thick fluid rich in immune cells, proteins, and debris produced during infection and inflammation.This impairs gas exchange and can lead to consolidation of lung tissue. The infection may be caused by a...