Pneumonia may have rapid onset and progression but does not resolve quickly. There should not be rapid resolution of the finding or contradictory information in a subsequent imaging test which suggests the finding is attributable to another condition (for example, 2 days later the opacity is now attributed to pulmonary edema). This includes but is not limited to new or worsening infiltrate, consolidation, opacity, or air space disease that is not attributed to something other than pneumoniaĮvidence of persistence.

The findings must provide evidence of pneumonia. VAE and PNEU/VAP surveillance PedVAE and PedVAP surveillance LRI: Surveillance for non-pneumonia lower respiratory infections (using LUNG definition) is available for “off-plan” surveillance in mechanically-ventilated or non-mechanically-ventilated adults, children, and neonates.PNEU: PNEU surveillance is available for “off-plan” surveillance in non-mechanically-ventilated adults, children, and neonates in any inpatient location.PedVAE: PedVAE surveillance can be done “off-plan” in mechanically-ventilated inpatients in neonatal and pediatric locations only.PedVAP or PNEU/VAP: Surveillance using the PNEU protocol is available for “off-plan” surveillance in all mechanically-ventilated inpatients (adults, children, or neonates) in any inpatient location.VAE: VAE surveillance can be done “off-plan” in mechanically-ventilated inpatients in adult locations only.What lower respiratory tract event surveillance can be done “off-plan”? This includes ventilated or non-ventilated adults, children, or neonates in any patient location. NOTE: When conducting CLABSI surveillance, the PNEU definition is available for use as a site-specific infection to which a bloodstream infection can be attributed as a secondary BSI for all patients, all locations, regardless of use of mechanical ventilation. Adult locations are excluded from PedVAE surveillance (even in circumstances where an adult unit may occasionally care for pediatric patients). PedVAE: This event is available for in-plan surveillance of mechanically ventilated inpatients in pediatric and neonatal locations only.In-plan surveillance for ventilator-associated PNEU (VAP) is not available for inpatients in adult or neonatal locations. PedVAP: This event uses the PNEU protocol and is available for in-plan surveillance of mechanically ventilated inpatients in pediatric locations only (regardless of the age of the patient).Pediatric and neonatal locations are excluded from VAE surveillance (even in circumstances where a pediatric unit may occasionally care for adult patients). VAE: This event is available for in-plan surveillance of mechanically ventilated inpatients in adult locations only (regardless of the age of the patient).What lower respiratory tract event surveillance can be done “in-plan”? A facility makes no commitment to follow the protocol for “off-plan” events. Data that are entered into NHSN “off-plan” are not used or reported in NSHN annual reports or other NHSN publications. “Off-plan” surveillance is surveillance that is done because you/your facility have decided to track a particular event for internal use.

Keep in mind that “in-plan” surveillance means that you/your facility have committed to following the NHSN surveillance protocol for that particular event in your NHSN monthly reporting plan. Let’s review what is available for in-plan or off-plan surveillance of lower respiratory tract events in NHSN. We need to consider events occurring in patients on mechanical ventilation and events occurring in patients NOT on mechanical ventilation, and we have to consider events that occur in adults and events that occur in neonates and in children. We know this can be an area of confusion.

Aspiration pneumonia lung sounds