Antibiotic selection for patients in ICU

What It Means
The percentage of patients who are in the Hospital Intensive Care Unit (ICU) with Pneumonia who receive antibiotics during the first 24 hours that is consistent with current North American Antibiotic Guidelines.

Why It Is Important
The North American Antibiotic Guidelines for treatment of community acquired pneumonia are developed by the Centers for Disease Control and other health care organizations. Treatment with the recommended antibiotic is associated with improved survival.

Numerator Definition
Pneumonia patients who received an initial antibiotic regimen consistent with the North American Antibiotic Guidelines during the first 24 hours of their hospitalization.

Denominator Definition
Pneumonia patients 18 years of age and older.

Denominator Excluded Populations

  • Patients received in transfer from an acute care facility where they were an inpatient or outpatient
  • Patients received as a transfer from one distinct unit of the hospital to another distinct unit of the same hospital
  • Patients received as a transfer from an emergency department of another hospital
  • Patients received as a transfer from an ambulatory surgery center
  • Patients who have no diagnosis of pneumonia either as the ED final diagnosis/impression or direct admission diagnosis/impression
  • Patients receiving Comfort Measures Only on day of or day after arrival
  • Patients transferred to another acute care hospital or federal hospital on day of or day after arrival
  • Patients who expired on day of or day after arrival
  • Patients who left against medical advice on day of or day after arrival
  • Patients who are Compromised as defined in the Data Dictionary
  • Pneumonia patients not in the ICU (PN-6a only)
  • Pneumonia patients in ICU (PN-6b only)
  • Patients involved in clinical trials
  • Patients with Healthcare-Associated Pneumonia as defined in the Data Dictionary
  • Patients who had no chest x-ray or CT scan that indicated abnormal findings within 24 hours prior to hospital arrival or anytime during this hospitalization
  • Pneumonia patients with another suspected source of infection who did not receive an antibiotic regimen recommended for pneumonia, but did receive antibiotics within the first 24 hours of hospitalization
  • Patients with Cystic Fibrosis (Appendix A, Table 3.4)
  • Patients with an Identified Pathogen as defined in the Data Dictionary
  • Patients who only received antibiotics prior to hospital arrival
  • Patients who have a Length of Stay >120 days

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