In the pre-admission process:

• Do you have a listing of services/capabilities to ensure your facility meets the specific acuity level of the patient or resident?
• Are the hospital discharge instructions complete and include advance directives?
• Does your facility have a process in place to ensure readiness for admissions?

In the post-admission process:

• Are you doing quality rounding for at least the first seven days? Is upper management involved?
• Are nurses proficient in clinical assessment skills? How do you educate your staff members?
• Are you using Situation, Background, Assessment, Recommendation (SBAR) or an equivalent system to ensure proper/informed communication?

In the discharge planning process:

• Are you starting the discharge process upon admission? Is it interdisciplinary?
• Are you properly discharging patients and residents with clear/concise instructions?
• Is social services completing a post-discharge follow-up to ensure patient or resident well-being?

If a patient is considered high-risk because of their age and overall health, you may choose to do additional tests, including:

• CT scan of the chest to get a better view of the lungs and look for abscesses or other complications
• Arterial blood gas test, to measure the amount of oxygen in a blood sample taken from an artery, usually in the wrist. This is more accurate than the simpler pulse oximetry.
• Pleural fluid culture, which removes a small amount of fluid from around tissues that surround the lung, to analyze and identify bacteria causing the pneumonia
• Bronchoscopy, a procedure used to look into the lungs’ airways. If the patient is hospitalized and treatment is not working well, you may want to see whether something else is affecting your airways, such as a blockage. You may also take fluid samples or a biopsy of lung tissue.

• Clean, disinfect and rinse with sterile water between treatments on the same patient
• Allow to dry and store in a manner that prevents contamination
• Use only sterile fluid and medication and dispense into the nebulizer aseptically
• Use single-dose medication whenever possible
• If multidose vials are used, follow manufacturer instructions for storage and use no more than 28 days from date of opening or until the expiration date (whichever is first)

• Follow manufacturer instructions for use
• Tubing, prongs and masks should be single-patient use and changed weekly if visibly contaminated or malfunctioning (or according to organization policy)