Nurses' knowledge and application of evidence-based guidelines for preventing ventilator-associated pneumonia.

Aim.. The aim of the study was to evaluate the nurses' knowledge and to highlight the causes that hinder guidelines implementation. Methods. Experimental design: descriptive study. Setting and participants: 106 nurses working in the ICUs of a major Italian hospital of national importance. Intervention: administration of a questionnaire listing 21 non-pharmacological strategies considered the most useful in the literature. Results. Eighty-four nurses responded to the questionnaire. Only 19 (22.6%) declared that their knowledge of ventilation associated pneumonia (VAP) and the strategies used to prevent it were satisfactory, whereas 46 (54.8%) declared that they were poorly informed; 68 nurses (80.9%) said that they applied one or more strategies, and 15 (17.9%) that they applied none. The reasons given for not applying the strategies were: method not foreseen in Department protocols (31.5%), lack of the necessary resources (14.3%), disagreement with the method (3.2%), high costs (2.6%), the possibility of causing discomfort (1%) or side effects (0.6%). Conclusion. In our experience, VAP preventive strategies are widely applied by nurses, but not in a responsible and informed manner. It is important to ensure that nurses receive continuous training and are involved in drawing up and updating Departmental protocols and guidelines for care and behaviour.