Implementing selective digestive tract decontamination in the intensive care unit: A qualitative analysis of nurse-identified considerations.
OBJECTIVE
To describe factors senior critical care nurses identify as being important to address when introducing selective digestive tract decontamination (SDD) in the clinical setting.


BACKGROUND
Critically ill patients are at risk of developing ventilator-associated pneumonia (VAP). SDD is one strategy shown to prevent VAP and possibly improve survival in the critically ill.


METHODS
We performed a secondary analysis of qualitative data obtained from 20 interviews. An inductive thematic analysis approach was applied to data obtained from senior critical care nurses during phase two of a multi-methods study.


RESULTS
There were four primary considerations identified that should be addressed or considered prior to implementation of SDD. These considerations included education of health care professionals, patient comfort, compatibility of SDD with existing practices, and cost.


CONCLUSIONS
Despite a lack of experience with, or knowledge of SDD, nurses were able to articulate factors that may influence its implementation and delivery. Organizations or researchers considering implementation of SDD should include nurses as key members of the implementation team.
Centre for Health Practice Innovation, Griffith Health Institute, Griffith University, Parklands Drive, Southport, Queensland 4222, Australia; The Gold Coast University Hospital, 1 Hospital Blvd, Southport, Queensland 4215, Australia. Electronic address: andrea.marshall.au@gmail.com.
Andrea P
AP
Marshall
Intensive Care Unit, Nepean Hospital, Derby Street, Penrith, NSW 2750, Australia.
Leonie
L
Weisbrodt
Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College St, Suite 276, Toronto, Ontario M5T 1P8, Canada.
Louise
L
Rose
Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, UK.
Eilidh
E
Duncan
Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, UK.
Maria
M
Prior
Department of Family and Community Medicine, University of Toronto, 500 University Avenue, 5th Floor, Toronto, Ontario M5G 1V7, Canada.
Laura
L
Todd
Centre for the Study of Social and Legal Responses to Violence, University of Guelph, Guelph, Ontario, Canada.
Elisabeth
E
Wells
Intensive Care Unit, Nepean Hospital, Derby Street, Penrith, NSW 2750, Australia; Sydney Medical School (Nepean), University of Sydney, Australia; Critical Care and Trauma Division, The George Institute for Global Health, Australia.
Ian
I
Seppelt
Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Room D128, Toronto, Canada; Interdepartmental Division of Critical Care, University of Toronto, Toronto, Canada.
Brian
B
Cuthbertson
Health Services Research Unit, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen AB25 2ZD, UK; School of Health Sciences, City University London, Room C332, Tait Building, Northampton Square, London EC1V0HG, UK.
Jill
J
Francis
D000328:Adult; D019072:Antibiotic Prophylaxis / Q000451:nursing*; D001291:Attitude of Health Personnel; D002983:Clinical Competence; D064648:Critical Care Nursing; D016638:Critical Illness; D003697:Delphi Technique; D005260:Female; D041981:Gastrointestinal Tract / Q000382:microbiology*; D006801:Humans; D007362:Intensive Care Units; D008875:Middle Aged; D053717:Pneumonia, Ventilator-Associated / Q000517:prevention & control*; D036301:Qualitative Research
Antibiotic prophylaxis; Critical illness; Implementation; Selective decontamination of the digestive tract; Ventilator-associated pneumonia