Nurse-led community-acquired pneumonia screening halves hospital mortality

Acute medical admissions model should be used to ease NHS winter pressures, say researchers

A nurse-led service has reduced hospital deaths from community acquired pneumonia (CAP) – and could be used to ease winter pressures in the NHS.

The specialist pneumonia intervention service screens acute medical admissions for CAP, which is the leading cause of hospital-based mortality.

A five-year study by University Hospitals Leicester NHS Trust found the death rate from CAP fell in the first year of the service, and further still in the second year.

‘Potential to save thousands of lives’

Researchers are now recommending the specialist service be adopted across the health service, saying it has the potential to save thousands of lives each year.

Consultant respiratory physician Gerrit Woltmann, who set up the service, said: 'Many NHS hospitals face problems with pneumonia mortality. The creation of our pneumonia nursing posts to ensure rapid delivery of evidence-based care has worked. We are now saving many more lives while reducing NHS costs.'

The service consisted of two specialist pneumonia nurses working at Glenfield Hospital and Leicester Royal Infirmary during daytime hours.

The pair provided rapid activities such as:

• Confirmation of CAP by chest X-ray.
• Scoring disease severity.
• Guided antibiotic therapy.

Researchers found the overall death rate from CAP within 30 days of admission fell in the first year of the service from 23% to 17%. By the second year, the rate had halved to 11.5%.

The service has now been expanded to five nurses with the hope of it supporting medical emergency teams during winter months. Its results were presented to the British Thoracic Society Winter Meeting today.

Advantages of earlier diagnosis 

Trust pneumonia nurse specialist Julie Skeemer said: 'We can help spot the signs earlier, which ensures no time is wasted for pneumonia patients but also for other patients as medical time is used more effectively. Consultants can treat other patients. 

‘Once the diagnosis has been made we make sure patients receive appropriate treatment. We empower patients by explaining things in a clear way and educate them on their treatment and diagnosis.'

A six-week follow-up X-ray clinic is part of the service, allowing patients to go home feeling reassured, she added.

Pneumonia and flu caused 269,313 emergency hospital admissions in the UK in 2016/17, costing the NHS an estimated £1 billion.

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