I COUGH After Surgery, Shouldn't You?

Ventilator-associated pneumonia and care bundles to prevent its incidence are a common focus of quality improvement efforts, but strategies to prevent postoperative pulmonary complications are less well-studied. Investigators at an urban-based safety net hospital in Boston leveraged their status as a negative outlier in National Surgical Quality Improvement Program (NSQIP) metrics to develop a multidisciplinary team effort focused on preventing pulmonary complications after surgery. Implementation of the program constituted an array of nursing care interventions, reinforced by patient and family counseling, and triggered by an electronic standardized order set. The major components of the intervention program are:

• Incentive spirometry

• Coughin…