Jansson Miia, Ala-Kokko Tero, Ylipalosaari Pekka, Syrjälä Hannu, Kyngäs Helvi
Institute of Health Science, University of Oulu, Finland.
Intensive Crit Care Nurs. 2013 Aug;29(4):216-27. doi: 10.1016/j.iccn.2013.02.006. Epub 2013 Apr 6.
To explore critical care nurses' knowledge of, adherence to and barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia.
A quantitative cross-sectional survey.
Two multiple-choice questionnaires were distributed to critical care nurses (n=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.
The mean score in the knowledge test was 59.9%. More experienced nurses performed significantly better than their less-experienced colleagues (p=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.
There is an ongoing need for improvements in education and effective implementation strategies.
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.
探讨重症监护护士对预防呼吸机相关性肺炎循证指南的知晓情况、遵循情况及面临的障碍。
定量横断面调查。
2010年秋季，向芬兰一个学术中心的101名重症监护护士发放了两份多项选择题问卷。采用独立样本t检验比较不同组重症监护护士的知识水平和遵循情况。运用归纳性内容分析法的原则分析预防呼吸机相关性肺炎循证指南面临的障碍。
知识测试的平均得分率为59.9%。经验更丰富的护士表现明显优于经验较少的同事（p = 0.029）。自我报告的总体遵循率为84.0%。自我报告的循证指南主要障碍包括资源不足、对结果存在分歧以及缺乏时间、技能、知识和指导。
持续需要改进教育和有效的实施策略。
研究结果可用于指导当地实践，并激发关于预防呼吸机相关性肺炎措施的讨论。应制定和更新教育、指南以及呼吸机集束方案和工具，以改善感染控制。
