Evidence-based guidelines for preventing ventilator-associated pneumonia: results of a knowledge test among 3329 European intensive care nurses

Introduction

Although evidence-based guidelines for preventing ventilator-associated pneumonia (VAP) are available, non-adherence by ICU clinicians seems common. This may, at least partly, be due to a lack of knowledge of the recommendations. Our study aimed to assess ICU nurses' knowledge of evidence-based VAP prevention recommendations.

Methods

A European survey by means of a validated and reliable multiple-choice questionnaire concerning nine evidence-based strategies for VAP prevention [1, 2]. Data gathered were gender, years of ICU experience (<1 years, 1–5 years, 6–10 years, >10 years), number of ICU beds (<8 beds, 8–15 beds, >15 beds), and whether they hold a specialized qualification in intensive care.

Results

Between November 2006 and April 2007, 3,329 questionnaires were gathered from 22 European countries. The nurses' mean score was 4.06/9 (45.1%). No differences were found between males and females. Nurses with a longer ICU working experience scored significantly better than their less experienced colleagues (P < 0.001 for <1 year vs >1 year and for <5 years vs >5 years of experience; P = 0.001 for <10 years vs >10 years of experience). Respondents from larger ICUs obtained significantly lower scores than those from smaller units (P < 0.001 for <8 beds vs >8 beds and P = 0.048 for <15 beds vs >15 beds). Linear regression analysis demonstrated knowledge to be independently associated with years of ICU experience, and with the number of ICU beds (both P < 0.001).

Conclusion

European nurses' knowledge of VAP prevention guidelines is poor. We recommend including VAP prevention guidelines in the core nurse education curriculum and in continuing refresher nursing education programs.