A Reading on

NOSOCOMIAL INFECTIONS

A Journal Reading Presented to the Faculty of San Pedro College

In Partial Fulfillment of the Requirements in NCM 209 - RLE

PEDIATRIC WARD NURSING ROTATION

Submitted to:

Charmaine A. Orocio, RN

Clinical Instructor

Submitted by:

Immanuel John G. Jurilla, St. N

BSN 2L – GROUP 2

April 20, 2023

Title: Research on the economic loss of hospital acquired pneumonia caused by
Klebsiella pneumonia base on propensity score matching

Bibliography:
Zhong, X., Wang, D. L., & Xiao, L. H. (2021). Research on the economic loss of
hospital-acquired pneumonia caused by Klebsiella pneumonia base on
propensity score matching. Medicine, 100(15).

‌Summary:

Hospital acquired pneumonia (HAP) caused by Klebsiella pneumonia (KP)

is a prevailing nosocomial infection (NI), but there are only a few studies on the
economic burden of of hospital-acquired pneumonia that is caused by KP (KP-
HAP). The authors’ goal for this study is to examine the direct effect of KP-HAP
on the economic loss of patients with propensity score matching (PSM) as their
method to serve as a basis for the cost accounting of NI and provide references
for creating infection control procedures.

A retrospective study was conducted on the hospitalization information of

patients, from a tertiary group hospital in Shenzhen, China who were discharged
from 2016 to 2019. According to the criteria for inclusion and exclusion of the
authors, patients were divided into the HAP group and noninfection group, the
extended-spectrum beta-lactamases (ESBLs) positive KP infection group, and
the ESBLs-negative KP infection group. Then using PSM, the baselines of each
group were balanced and the hospital cost and length of stay (LOS) of each
group were compared. The baselines of each group showed no difference after
the use of PSM. Compared to the noninfection group, the average LOS in the
KP-HAP group increased by 15 days (2.14 times), and the median hospital costs
increased by 7329 yuan (0.89 times). Compared with the ESBLs-negative KP-
HAP group, the median LOS in the ESBLs-positive KP-HAP group increased by
7.5 days (0.39 times), and the median hospital costs increased by 22,424 yuan
(1.90 times).
In conclusion, KP-HAP lengthened LOS and raised hospital costs, and HAP
caused by ESBLs-positive KP had higher economic losses than ESBLs-negative,
which deserves our attention and should be controlled by practical measures.

Reaction:

The authors’ concerns in their journal were regarding how much time and
money may be spent due to HAP and did their best to reduce any bias in their
study, based in their discussion. They also aimed to tackle KP-HAP specifically
since it was an understudied subject based in their review of literature so overall,
I agree with the purpose of the journal. Also, throughout my read, I have gained
new knowledge and realized how common nosocomial infections really are and
how it affects people financially. It is quite saddening that these infections are not
the patient’s fault, but they are still the ones who have to pay for the additional
treatment. However, it also may be because of the increased burden on nurses
in specially densely populated places such as China, where this study took place,
so we cannot really blame the healthcare providers either.

I personally have no related experience to share regarding the topic,

instead I wish to relate the journal to a model I have learned called the continuum
of care. The continuum of care aims for patients to “shift left” where the patient
attains independent care thus having less cost. This model is especially relevant
to the journal since it talks about lessening the time in the hospital and reducing
expenses. And I believe that the application of this model is essential.

The positive effect that I see this journal having is making its readers, who
are usually healthcare practitioners and professionals, more conscious of the
economic loss that could happen in an instance of a HAP. By being conscious of
the situation, it may persuade them to strive for better care, especially to those
who are higher ups in the hospital and can improve the overall system of the
place. The article also gave report on the understudied KP-HAP which added to
the resources now available on the web for future researchers to use. I
personally do not see any negative impacts that this article may have.
 In the context of nursing, this journal can be valuable since it provides
information which is otherwise looked over. The degree of economic loss related
to the type of nosocomial infection that the patient acquired gives insight to
nurses, nursing practitioners, and researchers. With this insight they are able to
make more knowledgeable decisions, now knowing the extent of which these NIs
affect their patients.