Intensive care nurses' knowledge of evidence-based guidelines for the prevention of ventilator-associated pneumonia

Introduction

Nonadherence to evidence-based guidelines for the prevention of ventilator-associated pneumonia (VAP) has been reported. As a lack of knowledge may be a barrier for adherence, this study aimed to determine intensive care nurses' knowledge of evidence-based guidelines for VAP prevention.

Methods

This study is a survey using a validated multiple-choice questionnaire, developed to evaluate nurses' knowledge of VAP prevention and based on a recently published review by Dodek and colleagues [1]. Knowledge of nine nursing-related strategies was evaluated. The questionnaire was distributed and collected during the Flemish Society for Intensive Care Nurses' annual congress (Ghent, 2005). Demographic data included were gender, intensive care experience, number of critical beds and whether nurses hold a special degree in emergency and intensive care.

Results

We collected 638 questionnaires (response rate 75%). Nineteen per cent recognized the oral route as the recommended way for intubation. Forty-nine per cent knew that ventilator circuits are to be changed for each new patient only. Heat and moisture exchangers were checked as the recommended humidifier type by 55%, and 13% knew that it is recommended to change them once weekly. Closed suction systems were identified as recommended by 69%, and 20% knew that these must be changed for each new patient only. Respectively 60% and 49% recognized subglottic drainage systems and kinetic beds to reduce the incidence of VAP. Semirecumbent positioning is well known to prevent VAP (90%). The nurses' average score was 4.2/9, while nurses with >1 year experience and those holding a special degree both scored 4.5/9 (P < 0.001).

Conclusion

Nurses lack knowledge of evidence-based guidelines for VAP prevention. Their schooling and continuing education should include support from current evidence-based guidelines.