Management of pneumonia in the nursing home.

Abstract

Pneumonia is a major cause of morbidity and mortality among nursing home residents. The approach to managing these patients has lacked uniformity because of the paucity of clinical trials, complexity of underlying comorbid diseases, and heterogeneity of administrative structures. The decision to hospitalize nursing home patients with pneumonia varies among institutions depending on staffing level, availability of diagnostic testing, and laboratory support. In the absence of comparative studies, choice of empirical antibiotic therapy continues to be based on expert opinion. Validated prognostic scoring models are needed for risk stratification. Pneumococcal and influenza vaccination are the primary prevention measures. As of January 2010, Medicare no longer pays for consultation codes; thus, practitioners must instead use existing evaluation and management service codes when providing these services.

• Authors: Ali A El-Solh, Mike S Niederman, Paul Drinka
• Journal: Chest (Chest) Vol. 138 Issue 6 Pg. 1480-5 (Dec 2010) ISSN: 1931-3543 [Electronic] United States
• PMID: 21138884 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Influenza Vaccines
• Pneumococcal Vaccines

Topics

• Aged
• Cross Infection (prevention & control)
• Female
• Guidelines as Topic
• Homes for the Aged
• Hospitalization (statistics & numerical data)
• Humans
• Incidence
• Influenza Vaccines (administration & dosage)
• Male
• Needs Assessment
• Nursing Homes
• Pneumococcal Vaccines (administration & dosage)
• Pneumonia (epidemiology, prevention & control, therapy)
• Primary Prevention (methods)
• Prognosis
• Risk Assessment
• Severity of Illness Index
• Survival Rate
• United States (epidemiology)
• Vaccination (standards, trends)