What Does Evidence-Based Practice Research Say About Pneumonia?
1. PREVENTION
To prevent pneumonia admissions, we must first focus on stopping the transmission of the bacteria that causes pneumonia.
Pneumonia can be classified into two categories based on how the infection was acquired:
Community-acquired pneumonia (CAP): Most common type
Nosocomial pneumonia
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Hospital-acquired pneumonia (HAP)
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Ventilator-associated pneumonia (VAP)
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Healthcare-associated pneumonia (HCAP)
What precautions are proven to help prevent Pneumonia?
DROPLET PRECAUTIONS
Droplet precaution means that the disease-causing bacteria is transmitted by coughing, sneezing, talking and close contact with an infected person’s breathing. Droplets are about 30-5- micrometers in size.
Droplets precautions include:
- Proper hand hygiene before entering the room.
- Donning the correct PPE: Gloves, surgical mask, gown and eye protection.
- PPE must be removed upon exit of the room
- Never reuse a mask
- Maintain a distance of 6 feet unless necessary.
VACCINATIONS
Research evidence: The CDC, WHO, and IDSA/ATS all recommend pneumococcal (PCV15, PCV20) and influenza vaccines to significantly reduce pneumonia incidence and severity, especially in older adults and immunocompromised patients.
Study support: A study in The Lancet (2021) confirmed pneumococcal vaccination reduces hospital admissions for pneumonia.
Check out this article on the CDC recommendation for pneumococcal vaccinations by age and risk groups.
STANDARD PROCEDURES
PROPER HAND WASHING
to prevent spread of bacteria
PROTECTIVE EQUIPMENT
before coming into contact with infected person
RESPIRATORY HYGIENE
covering mouth during cough/nose when sneezing
PROPER SANITATION
Properly disinfecting areas and supplies
❌NO SMOKING❌
Smoking damages mucociliary clearance and immune defenses.
Evidence: Clinical trials show smokers are up to 4 times more likely to develop pneumonia (American Journal of Respiratory and Critical Care Medicine, 2019).
2. ASSESSMENT & DIAGNOSIS
Rapid and accurate diagnosis improves outcomes.
Chest X-rays, blood cultures, sputum samples, and oxygen saturation levels help confirm pneumonia and assess severity.
EBP tools: Use scoring systems like CURB-65 or Pneumonia Severity Index (PSI) to guide treatment.
Study support: CURB-65 validated in multiple cohort studies, predicting 30-day mortality (BMJ, 2003).
What practices are proven to help treat Pneumonia?
3. TREATMENT
Early antibiotic therapy saves lives.
Starting antibiotics within 4–8 hours of diagnosis lower mortality.
Evidence: A landmark study in JAMA (Meehan et al., 1997) found a 15% reduction in mortality when antibiotics were started early in elderly patients with CAP.
Empiric therapy should follow guidelines.
Guidelines: IDSA/ATS (2019) recommend empiric treatment based on local resistance patterns and patient risk factors (e.g., macrolides or beta-lactams + doxycycline or fluoroquinolones for CAP).
Tailoring antibiotics improves outcomes.
Reassess at 48–72 hours and de-escalate based on cultures.
CDC Antibiotic Stewardship guidelines emphasize the importance of narrowing therapy to reduce resistance.
