Can surgeon familiarization with current evidence lead to a change in practice? A prospective study.
BACKGROUND
Despite evidence against its utility, many surgeons continue to employ prophylactic nasogastric decompression in elective colonic resection. This study aimed to establish whether an easy and practical intervention, mailing out a summary of current evidence to surgeons, can change surgeons practice to bring it more in line with current evidence.


METHODS
The use of prophylactic nasogastric (NG) decompression in elective colonic resections was documented for the 2 consecutive months of October and November, 2004 at the Royal Alexandra Hospital (RAH). A one page summary of recent evidence concerning this practice was then mailed to all general surgeons at that institution. A similar second review was carried out for the months of January and February, 2005. The two periods were compared with regards to prophylactic NG use.


RESULTS
Twenty two patients underwent elective colonic resections during the months of October and November, 2004. Twenty one patients underwent such procedures in January and February, 2005. Seven out of the 22 cases in the first group (the pre-intervention block) received prophylactic NG decompression. Five out of the 21 cases in the second group (the post-intervention block) received prophylactic NG decompression. The difference in prophylactic NG use between the two groups was not statistically significant.


CONCLUSIONS
This study has shown that mailing out a summary of current evidence to surgeons concerning a certain issue is not sufficient to lead to a change in practice.
Cadili
Ali
A
Dvorkin Lounge, University of Alberta Hospital, Edmonton, Alberta, Canada. acadili@ualberta.ca
de Gara
Christopher
C
D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003082:Colectomy / Q000379:methods*; D017558:Elective Surgical Procedures / Q000379:methods*; D019317:Evidence-Based Medicine; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000517:prevention & control; D010818:Practice Patterns, Physicians'; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016896:Treatment Outcome