Healthcare professional views on barriers to implementation of evidence-based practice in prevention of ventilator-associated events: A qualitative descriptive study

Intensive Crit Care Nurs. 2022 Feb:68:103133. doi: 10.1016/j.iccn.2021.103133. Epub 2021 Oct 27.

Abstract

Objective: To explore health professional views of barriers to the use of evidence-based practice to prevent ventilator-associated events in intensive care units.

Design: A qualitative descriptive study was conducted with nurses and doctors with more than six months experience caring for mechanically ventilated patients.

Setting: The study was conducted in two intensive care units, in large metropolitan health services in Victoria, Australia.

Methods: Individual semi-structured interviews were undertaken with 20 participants (16 nurses and 4 doctors) in 2019. Purposive sampling method was used until data saturation was reached. The interviews were held at the hospital in a private room away from their place of employment. The interview data were analysed using thematic analysis.

Findings: Four major themes were inductively identified from nine subthemes: i) prioritising specific situations, ii) inadequate use of evidence to underpin practice, iii) perception of inadequate staffing and equipment and, iv) inadequate training and knowledge of evidence-based guidelines.

Conclusions: These themes helped to explain previously reported deficits in nurses' knowledge of and adherence to evidence-based practice in intensive care. Findings suggest the need for a well-established policy to underpin practice. The barriers faced by nurses and doctors in preventing ventilator associated events need to be addressed to optimise quality of patient care in intensive care units.

Keywords: Barriers; Hospital-associated pneumonia; Infection prevention and control; Intensive care unit; Mechanical ventilation; Nosocomial pneumonia; Qualitative; Ventilator-associated events; Ventilator-associated pneumonia.

MeSH terms

  • Clinical Competence*
  • Delivery of Health Care
  • Evidence-Based Practice
  • Humans
  • Intensive Care Units
  • Nurses*
  • Qualitative Research
  • Ventilators, Mechanical
  • Victoria