Levy Gur, Perez Mario, Rodríguez Benito, Hernández Voth Ana, Perez Jorge, Gnoni Martin, Kelley Robert, Wiemken Timothy, Ramirez Julio
Servicio de Neumología, Hospital Universitario de Caracas, Caracas, Venezuela.
Servicio de Neumología, Hospital Universitario de los Andes, Mérida, Venezuela.
Arch Bronconeumol. 2015 Apr;51(4):163-8. doi: 10.1016/j.arbres.2014.03.008. Epub 2014 May 5.
The Community-Acquired Pneumonia Organization (CAPO) is an international observational study in 130 hospitals, with a total of 31 countries, to assess the current management of hospitalized patients with community-acquired pneumonia (CAP). 2 Using the centralized database of CAPO was decided to conduct this study with the aim of evaluate the level of adherence with national guidelines in Venezuela, to define in which areas an intervention may be necessary to improve the quality of care of hospitalized patients with CAP.
In this observational retrospective study quality indicators were used to evaluate the management of hospitalized patients with CAP in 8 Venezuelan's centers. The care of the patients was evaluated in the areas of: hospitalization, oxygen therapy, empiric antibiotic therapy, switch therapy, etiological studies, blood cultures indication, and prevention. The compliance was rated as good (>90%), intermediate (60% to 90%), or low (<60%).
A total of 454 patients with CAP were enrolled. The empiric treatment administered within 8 hours of the patient arrival to the hospital was good (96%), but the rest of the indicators showed a low level of adherence (<60%).
We can say that there are many areas in the management of CAP in Venezuela that are not performed according to the national guidelines of SOVETHORAX.1 In any quality improvement process the first step is to evaluate the difference between what is recommended and what is done in clinical practice. While this study meets this first step, the challenge for the future is to implement the processes necessary to improve the management of CAP in Venezuela.
社区获得性肺炎组织（CAPO）是一项在31个国家的130家医院开展的国际观察性研究，旨在评估社区获得性肺炎（CAP）住院患者的当前管理情况。2决定使用CAPO的集中数据库开展本研究，目的是评估委内瑞拉对国家指南的遵循程度，确定在哪些领域可能需要进行干预以提高CAP住院患者的护理质量。
在这项观察性回顾性研究中，使用质量指标评估了委内瑞拉8个中心的CAP住院患者的管理情况。在以下领域对患者护理进行了评估：住院、氧疗、经验性抗生素治疗、换药治疗、病因学研究、血培养指征和预防。依从性被评为良好（>90%）、中等（60%至90%）或低（<60%）。
共纳入454例CAP患者。患者入院后8小时内给予的经验性治疗良好（96%），但其余指标显示依从性较低（<60%）。
我们可以说，委内瑞拉CAP管理中的许多领域未按照SOVETHORAX的国家指南执行。1在任何质量改进过程中，第一步都是评估推荐做法与临床实践中实际做法之间的差异。虽然本研究完成了这第一步，但未来的挑战是实施必要的流程以改善委内瑞拉CAP的管理。
