Are you striving to improve ventilator-associated pneumonia (VAP) guideline adherence in your unit? Kiyoshi-Teo and colleagues surveyed 576 critical care nurses in 8 hospitals to identify factors that influence adherence to guidelines for prevention of VAP. From their findings, consider the following:

  • Nurses self-reported high adherence to oral hygiene and head-of-bed (HOB) elevation but less with spontaneous breathing trials (SBT).

  • Only 42.5% of nurses reported adequate time to complete oral hygiene but more than 70% did not see barriers to HOB and SBT.

  • The users’ attitudes toward each intervention were the most consistent predictor of adherence.

  • About half of the nurses reported reading the complete guidelines. Nurses may be more influenced by messages received through education and practice than through written guidelines.

Those working to implement guidelines need to consider the perceptions of the users of the guidelines when developing strategies for implementation....

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