Rello J, Lorente C, Bodi M, et al. Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia?
The article reflects the need to improve medical and nursing staff adherence to guidelines. A total of 110 opinion leaders on VAP from 22 countries were interviewed for their personal opinions on different VAP prevention measures Dapoxetine online. Scientific evidence published alone has been shown to be ineffective in improving guideline implementation because the degree of adherence is independent of the strength of evidence and the grade of effectiveness, at least in part because of the disagreement of opinion leaders about the interpretation of reported trials. However, the most important reason why recommendations are not followed is the lack of technological availability, which has been cited by 78% of the interviewed opinion leaders. Pharmacologic strategies had worse adherence than nonpharmacologic ones, which were predominantly conditioned for excessive antibiotic employment. This report highlighted the great importance of educational measures in improving VAP prevention, remarking on the need for a multidisciplinary approach.
Zack JE, Garrison T, Trovillion E, et al. Effect of an education program aimed at reducing the occurrence of ventilator-associated pneumonia.
This interesting article confirms the huge importance of implementing scientific data with educational programs, and is directed to physicians and nurses in an effort to improve VAP prevention. The reduction in the VAP rate reported is 57.6% (range, 12.6 to 5.7 episodes per 1,000 ventilator days). The program included a theoretical module, with selfstudy and practice modifications, with staff meetings and didactic lectures. The authors reinforced the programs with continuous visual support throughout the ICU, contributing to the adherence to the guidelines. These strategies require constant reinforcement by continuous updating and feedback based on results. It is important to point out that the combination of different measures is an important way to reduce the incidence of VAP. As can be inferred from the study, not only the incidence of VAP can be reduced with educational programs, but also the costs and patient morbidity attributed to nosocomial infections.
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