Sunanda Kale

Introduction/Problem

Community-acquired pneumonia (CAP) is a common diagnosis in urgent care with high mortality and morbidity rates (Ritchie & Roser, 2019). Diagnosis and treatment with clinical guidelines are essential for an effective outcome for the patient. CAP has early and late mortality and increases the cost of treatment worldwide. As per Center for Disease Control and Prevention (CDC) data, pneumonia and influenza were the eighth leading cause of death in all ages in 2020. (CDC, 2020). The common causes of pneumonia are streptococcus pneumoniae, mycoplasma pneumoniae, and recently added SARS-covid-19 to the list. Pneumonia is one of the respiratory illnesses with a poor prognosis and high mortality rate. Pneumonia debilitatingly affects a patient’s physical and financial aspects of life (Froes et al., 2019). There is a lack of follow-up with patients after visits to the emergency department. This creates a gap between health maintenance and management. These gaps can be closed with telemedicine without repeated visits to healthcare facilities.

Methods

Urgent care clinic nurse calls the patient 48 hours post-visit to urgent care diagnosed with pneumonia, pneumonitis, or a bacterial lung infection. The post-visit follow-up bundle ensures patients improve since their visit to urgent care. This intervention consists of assessing the patient’s health status, any questions regarding treatment, and follow-up with primary care.

Findings

This QI project did not significantly impact the reduction in emergency department visits and hospitalization. Telemedicine can manage patients well without repeated visits to urgent care or the emergency department. A nurse-led telephone follow-up bundle can help provide early intervention if patients are not responding to treatment.

Practice Implications

Using a follow-up bundle is helpful in systematically assessing a patient’s health and future management. Nurses can be a great asset in urgent care and be used to prevent future repeated visits to urgent care. The nurse-led follow-up bundle can be used in many high-risk diagnoses to manage patients in an outpatient setting. We can close those gaps with the use of telemedicine. Early intervention and treatment can be advised and administered to patients.