10 years of chart audit review from 2002
to 2012 were included. For the other two hospitals, data
were reviewed for the years 2010–2012. We used the International
Statistical Classification of Diseases and Related
Problems (ICD-9) codes for pneumonia not present
on admission, and verified the diagnosis with a confirmatory
x-ray demonstrating pulmonary infiltrate. Each
hospital setting had a significant incidence of previously
unreported NV-HAP (rates of 1.22–8.9 per 1,000 hospital
days).
In our review of the literature, only one study was
located that examined the incidence of NV-HAP in
all hospital units of a U.S. hospital system. Davis and
Finley (2012) reported a significant number of NV-HAP
within the Pennsylvania care system. They reported that
NV-HAP occurred on every type of hospital unit, had a
higher incidence rate, more deaths, and higher costs than
ventilator-associated pneumonia (Davis & Finley, 2012).
While the use of ICD-9 coding and x-ray is not sufficient
for an accurate diagnosis of pneumonia, the incidence
found in our preliminary study and in the Pennsylvania
report indicates that NV-HAP is a significant, yet unaddressed,
issue in healthcare.