Ask A Magnet Nurse: How Nurses Help Prevent Hospital-Acquired Pneumonia

Emmitt Smith, RN, Infection Control Practitioner, St. Joseph’s Hospital

Smart Living: Hospital-acquired pneumonia, or HAP, is a common infection that the staff of all hospitals must be prepared to prevent. What do the nurses at St. Joseph’s/Candler do to protect patients from HAP?

Emmitt Smith: Beyond hand-washing and other basic safety measures, the nurses have different protocols and procedures in place for each of the potential ways that a patient might get pneumonia during their stay. Any patient can get pneumonia, but some are at a higher risk.

SL: Who are the higher risk patients?

ES: Patients who have had a surgical procedure, especially an abdominal or chest procedure, may not be able to cough as well and clear their lungs. They are at a higher risk for post-procedure pneumonia. Nurses observe these patients and make sure that they cough and practice deep breathing.

Patients who are using a ventilator are at risk of acquiring pneumonia because they are intubated, which means they have a plastic tube placed through the mouth into the trachea, or windpipe. The tube becomes a route for germs because they are bypassing the normal defenses.

SL: Is that when nurses use what is called the ventilator bundle?

ES: Yes, the bundle is a series of practices that help with prevention of ventilator-associated pneumonia. These practices include frequent suctioning of respiratory secretions, oral care with an anti-bacterial product for the mouth, and keeping the head of the patient’s bed elevated. Nurses also coordinate with physicians to wean patients off of the ventilator as soon as possible.

SL: What other kinds of patients are at risk?

ES: Stroke patients are more likely to acquire aspiration pneumonia, where food or liquid gets into the lungs, because their swallowing mechanism is impaired and they can’t often feel that they are aspirating. These patients are closely observed and assisted with eating.

We also administer a pneumonia vaccine to some patients. Every patient that comes into our hospital is given an assessment, and the nurses screen patients for certain criteria that let them know a vaccine is needed. The criteria for the pneumonia vaccine includes being over age 65, having a long-term health problem such diabetes or heart disease, and having a condition that lowers the body’s resistance to infection, such as Hodgkin’s disease.

SL: Are patients at risk during recovery after a surgical procedure?

ES: Recovery mostly involves observation, and the nurses will be watching the patient’s breathing status anyway to make sure they are having no ill effects from anesthesia. Remember, nurses naturally assess patients every time they interact with them, not only for pneumonia but for any kind of issue. Watching for complications, making sure you are recovering well—for us, those kinds of things are automatic.
  • St. Joseph's Hospital Campus: 11705 Mercy Blvd., Savannah, GA 31419, (p) 912-819-4100
  • Candler Hospital Campus: 5353 Reynolds St., Savannah, GA 31405, (p) 912-819-6000
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St.Joseph's Hospital Campus: 912-819-4100

Candler Hospital Campus: 912-819-6000