- May 30, 2020
Research Article Review
Thearticle that is the subject of this paper concerns the implementationof clinical practice guidelines for ventilator-associated pneumonia[ CITATION Sin13 l 1033 ].Although there are numerous evidence-based guidelines developed toprevent, diagnose, and treat ventilator-associated pneumonia, thebest methods of implementing such guidelines are still unclear. Theaim of the study was therefore to measure the impact of educationalmethodologies, supported by reminders, and led by local opinionleaders, as strategies facilitating the implementation of the earliermentioned guidelines on ventilator-associated pneumonia rates andguidelines concordance.
Aprospective, multicenter, time-series study was used for thispurpose. The study took place over a period of two years in which 11trauma/surgical/medical ICUs lacking specific pre-existing approachesfor ventilator-associated guideline implementation. There were fourdata collection sessions, and for each of them, 30 consecutive adultsover the age of 16 were chosen to participate from each of the ICUs.Therefore, each data collection session had 330 patient participantswhile the study had 1320 patient participants in total.
Dueto the nature of the study topic, a significant outcome andmeasurable evidence was the rate of ventilator-associated pneumonia.The primary evidence however used by the researchers concernsconcordance with the recommendation for guideline implementation. Thelatter outcomes were analyzed using Pearson correlation coefficientsand multivariate analysis, although other statistical tools such aslogistic regression, paired ttest,and the Kruskal-Wallis test were used in the study.
Thestudy revealed that significant increases in concordance withguidelines as well as a high level of awareness of best practicesresults from a multifaceted introduction of ventilator-associatedguidelines. This multifaceted approach incorporates local opinionleaders, reminders, education, and implementation teams. Thisinformation is highly applicable within the practice setting sincenurses, including me, will be aware that multifaceted strategies arethe best for imparting information.
Sinuff, T., Muscedere, J., Cook, D. J., Dodek, P. M., Anderson, W., Keenan, S. P., . . . Heiland, D. K. (2013). Implementation of clinical practice guidlines for ventilator associated pneumonia: a multi center prospective study. Critical Care Medicine, 41(1), 15.