Adherence to institution-specific ventilator-associated pneumonia prevention guidelines

Hiroko Kiyoshi-Teo, Michael D. Cabana, Erika S. Froelicher, Mary A. Blegen

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. Objective To identify factors that influence adherence to guidelines for prevention of ventilator-associated pneumonia, with a focus on oral hygiene, head-of-bed elevation, and spontaneous breathing trials. Methods A cross-sectional descriptive study of critical care nurses at 8 hospitals in Northern California was conducted. A survey was created to gather information on possible facilitators of and barriers to adherence to institution-specific guidelines for preventing ventilator-associated pneumonia. User factors, guideline qualities, and contextual factors were explored and tested for possible relationships. Results A total of 576 critical care nurses participated in the survey. Each hospital had unique guidelines for preventing ventilator-associated pneumonia. In general, nurses had positive attitudes and reported adhering to the guidelines always or most of the time. Factors associated with adherence differed according to the intervention implemented. The score on the user attitude scale was the strongest and most consistent predictor of adherence across interventions (odds ratio, 3.49-4.75). Time availability (odds ratio, 1.54) and the level of prioritization (odds ratio, 1.86) were also significant predictors. Conclusion The most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.

Original languageEnglish (US)
Pages (from-to)201-215
Number of pages15
JournalAmerican Journal of Critical Care
Volume23
Issue number3
DOIs
StatePublished - 2014

Fingerprint

Ventilator-Associated Pneumonia
Guidelines
Nurses
Guideline Adherence
Odds Ratio
Critical Care
Oral Hygiene
Respiration
Cross-Sectional Studies
Head

ASJC Scopus subject areas

  • Critical Care

Cite this

Adherence to institution-specific ventilator-associated pneumonia prevention guidelines. / Kiyoshi-Teo, Hiroko; Cabana, Michael D.; Froelicher, Erika S.; Blegen, Mary A.

In: American Journal of Critical Care, Vol. 23, No. 3, 2014, p. 201-215.

Research output: Contribution to journalArticle

Kiyoshi-Teo, Hiroko ; Cabana, Michael D. ; Froelicher, Erika S. ; Blegen, Mary A. / Adherence to institution-specific ventilator-associated pneumonia prevention guidelines. In: American Journal of Critical Care. 2014 ; Vol. 23, No. 3. pp. 201-215.
@article{567fbdbc472d4bb7ad9ab9cec527c557,
title = "Adherence to institution-specific ventilator-associated pneumonia prevention guidelines",
abstract = "Background Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. Objective To identify factors that influence adherence to guidelines for prevention of ventilator-associated pneumonia, with a focus on oral hygiene, head-of-bed elevation, and spontaneous breathing trials. Methods A cross-sectional descriptive study of critical care nurses at 8 hospitals in Northern California was conducted. A survey was created to gather information on possible facilitators of and barriers to adherence to institution-specific guidelines for preventing ventilator-associated pneumonia. User factors, guideline qualities, and contextual factors were explored and tested for possible relationships. Results A total of 576 critical care nurses participated in the survey. Each hospital had unique guidelines for preventing ventilator-associated pneumonia. In general, nurses had positive attitudes and reported adhering to the guidelines always or most of the time. Factors associated with adherence differed according to the intervention implemented. The score on the user attitude scale was the strongest and most consistent predictor of adherence across interventions (odds ratio, 3.49-4.75). Time availability (odds ratio, 1.54) and the level of prioritization (odds ratio, 1.86) were also significant predictors. Conclusion The most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.",
author = "Hiroko Kiyoshi-Teo and Cabana, {Michael D.} and Froelicher, {Erika S.} and Blegen, {Mary A.}",
year = "2014",
doi = "10.4037/ajcc2014837",
language = "English (US)",
volume = "23",
pages = "201--215",
journal = "American Journal of Critical Care",
issn = "1062-3264",
publisher = "American Association of Critical Care Nurses",
number = "3",

}

TY - JOUR

T1 - Adherence to institution-specific ventilator-associated pneumonia prevention guidelines

AU - Kiyoshi-Teo, Hiroko

AU - Cabana, Michael D.

AU - Froelicher, Erika S.

AU - Blegen, Mary A.

PY - 2014

Y1 - 2014

N2 - Background Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. Objective To identify factors that influence adherence to guidelines for prevention of ventilator-associated pneumonia, with a focus on oral hygiene, head-of-bed elevation, and spontaneous breathing trials. Methods A cross-sectional descriptive study of critical care nurses at 8 hospitals in Northern California was conducted. A survey was created to gather information on possible facilitators of and barriers to adherence to institution-specific guidelines for preventing ventilator-associated pneumonia. User factors, guideline qualities, and contextual factors were explored and tested for possible relationships. Results A total of 576 critical care nurses participated in the survey. Each hospital had unique guidelines for preventing ventilator-associated pneumonia. In general, nurses had positive attitudes and reported adhering to the guidelines always or most of the time. Factors associated with adherence differed according to the intervention implemented. The score on the user attitude scale was the strongest and most consistent predictor of adherence across interventions (odds ratio, 3.49-4.75). Time availability (odds ratio, 1.54) and the level of prioritization (odds ratio, 1.86) were also significant predictors. Conclusion The most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.

AB - Background Various institution-specific guidelines have been developed to prevent ventilator-associated pneumonia. However, the availability of guidelines does not ensure adherence to recommended strategies. Objective To identify factors that influence adherence to guidelines for prevention of ventilator-associated pneumonia, with a focus on oral hygiene, head-of-bed elevation, and spontaneous breathing trials. Methods A cross-sectional descriptive study of critical care nurses at 8 hospitals in Northern California was conducted. A survey was created to gather information on possible facilitators of and barriers to adherence to institution-specific guidelines for preventing ventilator-associated pneumonia. User factors, guideline qualities, and contextual factors were explored and tested for possible relationships. Results A total of 576 critical care nurses participated in the survey. Each hospital had unique guidelines for preventing ventilator-associated pneumonia. In general, nurses had positive attitudes and reported adhering to the guidelines always or most of the time. Factors associated with adherence differed according to the intervention implemented. The score on the user attitude scale was the strongest and most consistent predictor of adherence across interventions (odds ratio, 3.49-4.75). Time availability (odds ratio, 1.54) and the level of prioritization (odds ratio, 1.86) were also significant predictors. Conclusion The most consistent facilitator of adherence to guidelines for prevention of ventilator-associated pneumonia was nurses' positive attitude toward the guidelines.

UR - http://www.scopus.com/inward/record.url?scp=84899682746&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84899682746&partnerID=8YFLogxK

U2 - 10.4037/ajcc2014837

DO - 10.4037/ajcc2014837

M3 - Article

C2 - 24786808

AN - SCOPUS:84899682746

VL - 23

SP - 201

EP - 215

JO - American Journal of Critical Care

JF - American Journal of Critical Care

SN - 1062-3264

IS - 3

ER -