Critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for the prevention of ventilator-associated pneumonia : a survey study

Abstract

<div lang="en" class="abs"><p class="abs_header">Abstract</p><p><em>Objectives:</em> To explore critical care nurses’ knowledge of, adherence to and barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia.</p><p><em>Design:</em> A quantitative cross-sectional survey.</p><p><em>Methods:</em> Two multiple-choice questionnaires were distributed to critical care nurses (<em>n</em> = 101) in a single academic centre in Finland in the autumn of 2010. An independent-samples t-test was used to compare critical care nurses’ knowledge and adherence within different groups. The principles of inductive content analysis were used to analyse the barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia.</p><p><em>Results:</em> The mean score in the knowledge test was 59.9%. More experienced nurses performed significantly better than their less-experienced colleagues (<em>p</em> = 0.029). The overall, self-reported adherence was 84.0%. The main self-reported barriers towards evidence-based guidelines were inadequate resources and disagreement with the results as well as lack of time, skills, knowledge and guidance.</p><p><em>Conclusion:</em> There is an ongoing need for improvements in education and effective implementation strategies.</p><p><em>Clinical implications:</em> The results could be used to inform local practice and stimulate debate on measures to prevent ventilator-associated pneumonia. Education, guidelines as well as ventilator bundles and instruments should be developed and updated to improve infection control.</p></div>