Critical Care Clinicians’ Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

Abstract

Background Ventilator-associated pneumonia is the most common hospital-acquired infection among patients receiving mechanical ventilation in an intensive care unit. Different initiatives for the prevention of ventilator-associated pneumonia have been developed and recommended. Objective To evaluate knowledge of critical care providers (physicians, nurses, and respiratory therapists in the intensive care unit) about evidence-based guidelines for preventing ventilator-associated pneumonia. Methods Ten physicians, 41 nurses, and 18 respiratory therapists working in the intensive care unit of a major tertiary care university hospital center completed an anonymous questionnaire on 9 nonpharmacological guidelines for prevention of ventilator-associated pneumonia. Results The mean (SD) total scores of physicians, nurses, and respiratory therapists were 80.2% (11.4%), 78.1% (10.6%), and 80.5% (6%), respectively, with no significant differences between them. Furthermore, within each category of health care professionals, the scores of professionals with less than 5 years of intensive care experience did not differ significantly from the scores of professionals with more than 5 years of intensive care experience. Conclusions A health care delivery model that includes physicians, nurses, and respiratory therapists in the intensive care unit can result in an adequate level of knowledge on evidence-based nonpharmacological guidelines for the prevention of ventilator-associated pneumonia. (American Journal of Critical Care. 2010;19:272-277) by AACN on April 4, 2019 http://ajcc.aacnjournals.org/ Downloaded from Although knowledge of the guidelines does not guarantee implementation and adherence, lack of knowledge may be a barrier to adherence to and implementation of VAP prevention guidelines. Many studies have focused on assessing the knowledge of ICU nurses regarding measures for the prevention of VAP. [9][10][11][12][13] Other ICU health care providers-particularly respiratory therapists, who are involved in controlling endotracheal cuff pressure, avoiding microaspiration of subglottic secretions, and controlling contamination of mechanical ventilator equipment-can have a significant effect on the prevention of VAP in patients receiving mechanical ventilation in the ICU. 14 The aim of this study was to assess the knowledge of ICU health care providers (ie, physicians, nurses, and respiratory therapists) related to evidence-based guidelines for prevention of VAP. MethodsA multiple-choice questionnaire consisting of 9 items (Table 1) that had been developed, validated, and tested by Blot et al 12 and Labeau et al 13 was distributed to all physicians, nurses, and respiratory therapists working in the ICU of a 420-bed university hospital. The ICU had 20 beds with an approximate daily average of 12 patients receiving mechanical ventilation. Any staff member who was aware of the previous 2 studies by Blot et al 12 and Labeau et al 13 was not allowed to participate in the study; such exclusion was intended to eliminate any po...

Patient to Nurse Ratio and Risk of Ventilator-Associated Pneumonia in Critically Ill Patients

“…14 Enhancement of knowledge of evidence-based recommendations to prevent VAP and multifaceted implementation of care bundles focused on measures to prevent VAP may reduce the risk for this pneumonia. [15][16][17][18][19][20][21][22] Yet, because of the high workload and degree of urgency needed in ICUs, proper compliance with recommendations is difficult. Furthermore, the shortage of qualified ICU nurses is a common problem in many European countries.…”

Evidence-Based Guidelines for the Prevention of Ventilator Associated Pneumonia: Results of Knowledge Test Among Anesthesia Residents Employed in ICU

“…Bu oran, El-khatib ve ark. 'nın (23) üç farklı grup yoğun bakım çalışanları arasında yaptığı anket çalışmasında sırasıyla; doktor grubunda % 90, hemşire grubunda % 76 ve solunum terapistleri grubunda % 89 olarak bildirmiştir. Blot ve ark.…”

“…(25) El-khatib ve ark. 'nın (23) çalışmasında; ventilatör devresinin değiştirme sıklığı ile ilgili soru, doktor grubunda % 70, hemşi-re grubunda % 68 ve solunum terapistleri grubunda ise % 84 oranında doğru yanıtlanmıştır. Isı ve nem değiştiricili nemlendiricilerin kullanılması gerektiği de gruplar tarafından sırasıyla % 80, % 84 ve % 88 oranlarında doğru yanıtlanmıştır.…”

“…'nın (19) ça-lışmasında bu oran % 90,3 iken, El-khatib ve ark. 'nın (23) çalışmasında ise; bu oranlar, doktor grubunda % 90, hemşire grubun-da % 97 ve solunum fizyoterapistleri grubunda ise % 81'dir.…”

Knowledge and Performance Level of Infection Control Guidelines on Indwelling Urinary Catheter, Central Venous Catheter and Ventilator Among Intensive Care Nurses

“…의료관련감염의 30～35%는 적극적인 감염관리로 예 방이 가능하고 [7] 감염관리에 대한 지식이 높을수록 수 행도도 높아 [8] 감염발생의 위험이 감소될 수 있다. 선행 연구에서 인공호흡기 관련 폐렴 예방에 대한 지식의 정 답률은 45.1～71% [8,9], 중심정맥관 관련 혈류감염 예방 에 대한 지식의 정답률은 43.6～44.4%였고 [8,10] …”