Abstract
OBJECTIVE: To understand the reported practices of and adherence to evidence-based guidelines for the prevention of ventilator-associated pneumonia (VAP) among respiratory therapists (RTs) and registered nurses (RNs) in academic and nonacademic intensive care units.
METHODS: We conducted a multicenter, cross-sectional survey. We first obtained demographic information about health care professionals in a nonidentifiable method. We next questioned the practice patterns of RTs and RNs for preventing VAP based on evidence-supported guidelines. The participants were RTs and RNs working in academic and nonacademic intensive care units; 278 respondents participated in this study (172 RTs and 106 RNs). There were no interventions.
RESULTS: The 3 major findings were: (1) both the RTs and the RNs reported that they frequently practice VAP-prevention measures, (2) the rate of adherence to ineffective measures (eg, routine changes of the ventilator circuit, disposable catheters) is also relatively high, which suggests that the evidence is not translated into bedside practice, (3) a substantial proportion of participants did not know the VAP rate in their institution, which might make it difficult to convince bedside practitioners to apply evidence-based practice, and might reflect a lack of infection-control/surveillance programs at hospitals.
CONCLUSION: Consumers, the Centers for Disease Control and Prevention, and other organizations are currently trying to implement mandatory reporting of hospital infections, including VAP rate. Without a definition of VAP suited to individual institutions, an organized data-collection and reporting method, and team-based approaches to preventing and treating VAP, hospitals may not be able to meet these requests and track improvement efforts. Prevention measures need to be translated to bedside practice to improve the outcomes of critically ill patients.
- prophylaxis
- ventilator-associated pneumonia
- guideline
- adherence
- compliance
- prevention
- behavioral modification
- implementation
- intensive care unit
Footnotes
- Correspondence: A Murat Kaynar MD, Departments of Critical Care Medicine and Anesthesiology, University of Pittsburgh School of Medicine, 3550 Terrace Street, Room 639 Scaife Hall, Pittsburgh PA 15261. E-mail: kaynarm{at}upmc.edu.
This research was performed at Beth Israel Deaconess Medical Center, Massachusetts General Hospital, Brigham and Women's Hospital, University of Massachusetts, Worcester, Massachusetts; and at meetings of the Society of Critical Care Medicine and the Rhode Island Society of Respiratory Care.
The authors report no conflicts of interest related to the content of this paper.
- Copyright © 2007 by Daedalus Enterprises Inc.
