Implementing selective digestive tract decontamination in the intensive care unit: A qualitative analysis of nurse-identified considerations

Marshall, A. P., Weisbrodt, L., Rose, L., Duncan, E. M., Prior, M. E., Todd, L., Wells, E. C., Seppelt, I., Cuthbertson, B. H. & Francis, J. (2014). Implementing selective digestive tract decontamination in the intensive care unit: A qualitative analysis of nurse-identified considerations. Heart and Lung: Journal of Acute and Critical Care, 43(1), pp. 13-18. doi: 10.1016/j.hrtlng.2013.09.002

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Abstract

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.

Item Type: Article
Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Heart & Lung: The Journal of Acute and Critical Car. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Heart & Lung: The Journal of Acute and Critical Care, Volume 43, Issue 1, January–February 2014, Pages 13–18, http://dx.doi.org/10.1016/j.hrtlng.2013.09.002
Uncontrolled Keywords: Antibiotic prophylaxis; Critical illness, Implementation, Selective decontamination of the digestive tract, Ventilator-associated pneumonia
Subjects: R Medicine > RC Internal medicine
Divisions: School of Health Sciences > Healthcare Research Unit
URI: http://openaccess.city.ac.uk/id/eprint/4845

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