Prevention of ventilator-associated pneumonia: Current practice in Canadian intensive care units☆,☆☆
Section snippets
Methods
We conducted a cross-sectional observational study of Canadian ICUs that had at least 8 beds. According to the Canadian Hospital Directory, 144 hospitals had more than 8 critical care or coronary care unit beds. We excluded hospitals that had less than 8 critical care beds because these units typically do not care for ventilated patients for more than 24 hours. An additional criterion for inclusion of participating ICUs was availability of a dietitian who consulted in the ICU (excluding
Results
Of the 79 dietitians who were sent study materials, 66 returned completed case report forms for a response rate of 83.5%. Questionnaires from Unit Directors were included in all 66 returned surveys. Characteristics describing the 66 participating ICUs are found in Table 2; 29 (44.0%) were university-affiliated ICUs and 47 (71.2%) were closed units.
University-affiliated 29 (44%) Community 12 (18%) Community with occasional medical residents 25 (38%) Type of ICU Open
Discussion
Recent guidelines have been developed for the prevention of VAP in critically ill patients.11, 13, 14, 15 However, there are no Canadian studies that document the gap between current practice and optimal practice by using these guidelines. In this study, we surveyed Canadian ICUs to determine the current practice related to VAP prevention and found a low rate of use of noninvasive ventilation and poor compliance with recommendations to decrease the frequency of ventilator circuit changes,
Acknowledgements
The authors would like to thank Rupinder Dhaliwal and Andrew Day for helping with the data analysis, and the dietitians who collected data for this study: John Pilgrim, Thunder Bay Regional Hospital; Gigi Farrell and Kim Fisher, Sault Area Hospital; Joy Hoard, William Osler Health Centre; Natalie Seurralt, Hotel Dieu Hospital, a division of R. H. S. J. Health Centre of Cornwall; Elizabeth Chan, The Scarborough Hospital, Grace Division, Nutrition and Food Services; Diana Calligan, Hamilton
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D.K.H. is a Career Scientist with the Ontario Ministry of Health. D.J.C. is a Canada Institute for Health Research Chair.
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Address reprint requests to Daren K. Heyland, MD, FRCPC, MSc, Angada 3, Kingston General Hospital, 76 Stuart St, Kingston, Ontario, Canada K7L 2V7. E-mail: [email protected].