Nursing Home–Acquired Pneumonia (NHAP)

Dangers of Nursing Home Flu Outbreaks

Nursing home–acquired pneumonia (NHAP) is any pneumonia infection that is contracted by anyone living in a nursing home or other long-term care facility. Nursing home–acquired pneumonia (NHAP) is very dangerous. Approximately 13% to 41% of all nursing home residents with NHAP that are transferred to a hospital for treatment will die.

What You Need to Know About Nursing Home Liability If Your Loved One Contracted NHAP

Dangers of Nursing Home Flu OutbreaksNHAP is different than from community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP).

Elderly nursing home residents are more likely than elderly people still living at home, but less likely than elderly patients in hospital settings, to contract antibiotic resistant pathogens that cause pneumonia. Elderly residents that live in nursing homes or other long-term care facilities are at great risk of getting pneumonia than elderly still living at home for many reasons.

Pneumonia spreads very easy in congested living spaces where shared dining, shared medical treatment, and poor hygiene all exist.

The following conditions that are common in nursing homes also contribute to a high risk of getting pnuemonia:

  • dysphagia which is difficulty swallowing;
  • chronic conditions like COPD, diabetes, asthma;
  • feeding tube and ventilator use;
  • cognitive impairments etc.

Pneumonia Prevention Programs in Nursing Homes

Nursing home must develop and implement adequate pneumonia prevention programs. The following are a few things nursing homes can do to prevent pneumonia infections in the nursing home:

  • Vaccinate all new residents against the Streptococcus pneumonia bacteria which is the main cause of bacterial pneumonia;
  • All residents should be administered the influenza vaccine prior to cold and flu season. Cold season runs from October to May. Influenza is the main cause of viral pneumonia. Viral pneumonia is not as common as bacterial pneumonia but it is just a dangerous;
  • Make sure medical equipment and common areas are thoroughly cleaned with disinfectant solutions capable of killing the bacteria and viruses that cause pneumonia;
  • Instruct staff on proper hand cleansing techniques and post signs near medical carts and in bathrooms to ensure compliance in order to prevent hand to hand transmission of pneumonia causes bacteria, pathogens and viruses.

Diagnosing Pneumonia in Nursing Homes

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Nursing homes have a duty to diagnose and treat pneumonia in a timely manner. Failure to diagnose and treat pneumonia in a timely manner could result in avoidable deaths. It could also result in the spread of pneumonia throughout the nursing home.

Nursing home staff  should call the physician anytime a nursing home resident begins experiencing serious respiratory symptoms. Nursing homes should always suspect a pneumonia if a resident starts experiencing a new cough or worsening cough in addition to a cognitive or functional decline, fever, trouble breathing/dyspnea, low oxygen levels, fever or chest pain.

Nurses should always take and record vital signs and oxygen saturation levels if there are pneumonia-like symptoms present in a resident. Once these symptoms are observed and recorded the physician should be contacted. The nursing home director should be notified if the physician does not get in contact with the treating nurse within one hour.

When the physician arrives he or she must first determine if pneumonia is a leading cause of the resident’s new symptoms.  To be safe pneumonia should be diagnosed until disproven.

Probable pneumonia should be diagnosed when two or more of the following symptoms are present in a nursing home resident: new cough or worse cough, temperature above 100.5 degrees, chest pain, cognitive or functional decline, increase respiratory rate of twenty five breaths every minute, new or worse hypoxia. Once the physician determines the resident has probable pneumonia he or she must then decide whether or not to send the resident to the hospital.

A physician should send a resident to the hospital if they have two or more of the following symptoms:

  • an oxygen saturation level below 90%;
  • systolic blood pressure below 90 mm hg;
  • respiratory rate greater than 30 breaths per minute;
  • presence of COPD, diabetes, congestive heart failure; irritability.

The resident should also be hospitalized if the nursing home (1) does not have laboratory access for blood work and diagnosis purposes, (2) does not have at least two licensed nurses working every shift, (3) is not able to perform a vital sign assessment every four hours.

Treating Pneumonia in Nursing Homes

Any nursing home resident with pneumonia that is not transferred to the hospital needs to be treated at the nursing home. A nursing home that has decided to keep a resident with pneumonia should (1) perform a vital sign assessment including oxygen saturation and respiratory rate every shift; (2) have the resident undergo a chest X-ray; (3) administer broad-spectrum antibiotics within four hours of a timely diagnosis.

Pneumonia Resulting in Sepsis

Sepsis is a potentially fatal condition that results when the human body’s immune system releases large amounts of chemicals into the blood in order to fight infections. The release of these chemicals into the bloodstream can cause inflammation throughout the body which can result in blood clots. Blood clotting can reduce blood flow to the body’s organs (heart, kidneys, liver, brain, etc). Organ failure results if the body’s organs are deprived of oxygen-rich blood.

Respiratory infections are the most common cause of sepsis and pneumonia is most common respiratory infection leading to sepsis. Sepsis is very hard to diagnose. Therefore any resident with pneumonia should be considered at risk of acquiring sepsis. Nursing homes therefore need to monitor all residents with pneumonia for signs of sepsis.

What Can You Do if You Suspect a Nursing Home is Liable for a Loved One’s Illness or Death?

Sometimes a nursing home can be held liable for a loved one’s injuries and their resulting complications, including death. When a nursing home neglects patient needs they may have committed a type of medical malpractice for which you can seek compensation.

If you believe your loved one has suffered any form of nursing home neglect or abuse, contact our experienced and compassionate nursing home neglect lawyers today for a free consultation.

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We offer a free, no-obligation legal consultation to help you understand your rights and the value of your case. Our personal injury law firm takes cases involving elder abuse and neglect. We offer legal service to clients in Massachusetts, Rhode Island and New Hampshire.

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