Interventions to prevent non-ventilator hospital-acquired pneumonia: A Making Healthcare Safer rapid review

Abstract

Background

Interventions to prevent non-ventilator hospital-acquired pneumonia (NV-HAP) was identified as a high priority patient safety practice (PSP) for inclusion in the Making Healthcare Safer IV review series by a multidisciplinary technical expert panel through the Agency for Healthcare Research and Quality (AHRQ) topic prioritization process.

Methods

We followed the AHRQ Evidence-based Practice Center Program's rapid review guidance. We searched PubMed, Embase, and the Cochrane Library to identify eligible systematic reviews from January 2019 to August 2024 and primary studies from January 2010 to August 2024. We included literature that addressed any PSPs intended to prevent NV-HAP among inpatients in U.S. hospitals. We registered the protocol in PROSPERO (CRD42024612917).

Results

We retrieved 4103 relevant citations. After title and abstract screening, 207 full-texts were assessed for eligibility, and 18 primary studies were included: six studies for oral care, seven studies for dysphagia screening and management, and five studies for prevention bundles (all five bundles included oral care as one component). Prevention bundle studies reporting NV-HAP incidence favored prevention bundles (Strength of Evidence: Low). For all other reported outcomes for each PSP, we rated the evidence as insufficient, mostly due to high study limitations and imprecision. Therefore, we were unable to draw conclusions about whether oral care, dysphagia screening and management are effective in preventing NV-HAP or other undesired outcomes.

Conclusion

The evidence supporting interventions for NV-HAP prevention is mostly limited and inconclusive. While prevention bundles showed potential benefits, further high-quality research is needed to improve patient outcomes through targeted, evidence-based interventions.