title: Nurses' implementation of guidelines for ventilator-associated pneumonia from the Centers for Disease Control and Prevention.
abstract: BACKGROUND
  Ventilator-associated pneumonia accounts for 47% of infections in patients in intensive care units. Adherence to the best nursing practices recommended in the 2003 guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention should reduce the risk of ventilator-associated pneumonia.
  
  
  OBJECTIVE
  To evaluate the extent to which nurses working in intensive care units implement best practices when managing adult patients receiving mechanical ventilation.
  
  
  METHODS
  Nurses attending education seminars in the United States completed a 29-item questionnaire about the type and frequency of care provided.
  
  
  RESULTS
  Twelve hundred nurses completed the questionnaire. Most (82%) reported compliance with hand-washing guidelines, 75% reported wearing gloves, half reported elevating the head of the bed, a third reported performing subglottic suctioning, and half reported having an oral care protocol in their hospital. Nurses in hospitals with an oral care protocol reported better compliance with hand washing and maintaining head-of-bed elevation, were more likely to regularly provide oral care, and were more familiar with rates of ventilator-associated pneumonia and the organisms involved than were nurses working in hospitals without such protocols.
  
  
  CONCLUSIONS
  The guidelines for the prevention of ventilator-associated pneumonia from the Centers for Disease Control and Prevention are not consistently or uniformly implemented. Practices of nurses employed in hospitals with oral care protocols are more often congruent with the guidelines than are practices of nurses employed in hospitals without such protocols. Significant reductions in rates of ventilator-associated pneumonia may be achieved by broader implementation of oral care protocols.
authors.affiliation: The School of Nursing, University of Texas at Arlington, TX 76109-0407, USA. CLCason@uta.edu
authors.forename: Carolyn L
authors.initials: CL
authors.lastname: Cason
authors.forename: Tracy
authors.initials: T
authors.lastname: Tyner
authors.forename: Sue
authors.initials: S
authors.lastname: Saunders
authors.forename: Lisa
authors.initials: L
authors.lastname: Broome
mesh_terms: D000328:Adult; D002487:Centers for Disease Control and Prevention, U.S.; D002983:Clinical Competence; D003422:Critical Care / Q000379:methods / Q000592:standards*; D003430:Cross-Sectional Studies; D004509:Education, Nursing, Continuing; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000193:education / Q000592:standards*; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D017410:Practice Guidelines as Topic; D012121:Respiration, Artificial / Q000009:adverse effects / Q000451:nursing*; D011795:Surveys and Questionnaires; D014481:United States