Department of Family Medicine, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
BMC Infect Dis. 2024 Sep 2;24(1):896. doi: 10.1186/s12879-024-09705-2.
Pneumonia stands as a significant global contributor to mortality, particularly in South Africa, where it ranks as the second leading cause of death. The country's high prevalence of HIV infection compounds this issue, significantly increasing mortality rates associated with community-acquired pneumonia (CAP).
This study aimed to audit CAP patient management at a regional rural hospital in KwaZulu-Natal.
A retrospective review of patient files from September to December 2016 was undertaken. Data extraction from clinical files, conducted according to inclusion criteria, was transferred to a data collection sheet and analyzed using SPSS version 21.
The review encompassed 124 patient files over four months, revealing that 117 (94.4%) patients were not managed by the Standard Treatment Guidelines and Essential Medicines List for South Africa. Of the patients admitted with CAP, 54% were HIV positive, and 49 (39.5%) patients succumbed to the illness. Notably, none of the patients underwent assessment using a severity score.
The findings underscore a need for more adherence to South African guidelines for managing CAP among staff at the rural regional hospital. This leads to severe consequences, exemplified by the high mortality rate. Urgent intervention is required to incorporate severity assessment scores into pneumonia evaluations, thus enabling appropriate clinical management.
This study sheds light on the significant impact of CAP within the South African hospital context, delineating critical gaps in clinical care and emphasizing the imperative to address clinical inertia.
肺炎是全球范围内导致死亡的主要原因之一，在南非尤其如此，肺炎是该国的第二大致死原因。该国艾滋病毒感染率高，这使得社区获得性肺炎（CAP）的死亡率显著上升。
本研究旨在审计夸祖鲁-纳塔尔省一家地区农村医院的 CAP 患者管理情况。
对 2016 年 9 月至 12 月期间的患者档案进行回顾性审查。根据纳入标准，从临床档案中提取数据并转移到数据收集表中，然后使用 SPSS 版本 21 进行分析。
在四个月的时间里，共审查了 124 份患者档案，结果显示，有 117 名（94.4%）患者未按照南非标准治疗指南和基本药物清单进行管理。在因 CAP 住院的患者中，有 54%为 HIV 阳性，有 49 名（39.5%）患者死亡。值得注意的是，没有患者接受过严重程度评分评估。
研究结果表明，农村地区医院的工作人员更需要遵守南非 CAP 管理指南。这导致了严重的后果，表现为高死亡率。迫切需要采取干预措施，将严重程度评估评分纳入肺炎评估，从而实现适当的临床管理。
本研究揭示了 CAP 在南非医院环境中的重大影响，指出了临床护理方面的关键差距，并强调了解决临床惰性的必要性。
