Blood culture for transfers to intensive care unit (ICU)

What It Means
The percentage of patients with pneumonia who are transferred or admitted to the ICU within 24 hours of hospital arrival, who have a blood culture performed within 24 hours of hospital arrival.

Why It Is Important
We know that when a patient with pneumonia has a blood culture (a test showing what disease organisms are present in the patient's blood) before receiving antibiotics, the physician has a much better idea how sick the patient really is and which antibiotic will be most helpful. If the antibiotics are given before the blood culture, the information the physician has to work with is not as clear and accurate.

Numerator Definition
Number of pneumonia patients transferred or admitted to the ICU within 24 hours of hospital arrival who had blood cultures performed within 24 hours prior to or 24 hours after arrival at the hospital.

Denominator Definition
Pneumonia ICU 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 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 had 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 less than 18 years of age
  • Patients not transferred or admitted to the ICU within 24 hours of hospital arrival
  • 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
  • Patients with Cystic Fibrosis (Appendix A, Table 3.4)
  • Patients involved in clinical trials
  • Patients who have a Length of Stay >120 days

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