Theme | Item | Mean Rank | P-Value |
---|---|---|---|
Communication between providers | They would benefit by receiving clinical progress reports feedback on VAP patients after they are discharged from the ICU | Physicians vs. respiratory therapists, 43.1 vs 72.4 | 0.03 |
Physicians vs. pharmacists, 43.1 vs 85.2 | 0.02 | ||
Could more readily access information on ICU patients from the EMR | Respiratory therapists vs. nurses, = 62.8 vs 85.0 | 0.02 | |
Difficulty in diagnosing VAP | Being able to perform a bronchoscopy in the ICU helps the physician to expeditiously diagnose VAP | Physicians aware of the guideline vs. those not aware of it, 57.4 vs 68.7 | 0.05 |
Education related to VAP and VAP management | Received effective training on VAP management | Participants aware of the guideline vs. those not aware of it, 56.7 vs 83.6 | <.01 |
Kept up-to-date on nosocomial infection literature | Participants aware of the guideline vs. those not aware of it, 54.73 vs 85.81 | <.001 | |
Could appropriately manage ICU patients with VAP | Participants aware of the guideline vs. those not aware of it, 58.14 vs 71.35 | 0.01 | |
Believe that they could easily interpret quantitative culture results related to VAP (applicable to physicians only) | Participants aware of the guideline vs. those not aware of it, 55.92 vs 72.17 | 0.01 | |
Believe that they could accurately diagnose ICU patients with VAP (applicable to physicians only) | Participants aware of the guideline vs. those not aware of it, 41.81 vs. 53.16 | 0.03 | |
Kept up-to-date on nosocomial infection literature | Pharmacists vs. nurses, 58.8 vs 83.9 | <.01 | |
Guideline awareness and use | ICU VAP management order sets would facilitate VAP management | Pharmacists vs. respiratory therapists, 51.5 vs 88.5 | <.01 |
Physicians vs. respiratory therapists, 54.6 vs 88.5 | <.01 | ||
VAP management guidelines interfere with their ability to manage my ICU patients | Respiratory therapists vs. pharmacists, 44.0 vs 72.1 | <.01 | |
Management of the condition | Having nurses float between ICUs interferes with standardized VAP patient management | *Participants aware of the guideline vs. those not aware of it, 70.1 vs 57.5 | <.001 |
Physicians are receptive to respiratory therapist input in ICU patient care | Physicians vs. respiratory therapists, 56.0 vs 87.9 | <.01 | |
Physicians are receptive to pharmacists’ input in ICU patient care | Physicians vs. respiratory therapists, 52.3 vs 79.5 | 0.02 | |
ICU patients with renal failure complicate decision-making when ordering antibiotics | Physicians vs. pharmacists, 35.6 vs 70.7 | <.01 | |
Physicians vs. respiratory therapists, 35.6 vs 79.2 | <.01 | ||
Nurses respiratory therapists, 56.1 vs 79.2 | 0.02 | ||
Provider responsibilities | It is effective to have pharmacists help determine the appropriateness of ICU antibiotic de-escalation | Participants aware of the guideline vs. those not aware of it, 57.8 vs 73.2 | <.001 |
Pharmacists vs. respiratory therapists, 49.9 vs 82.5 | <.01 | ||
Attending physicians should be responsible for educating house staff on VAP management guidelines | Participants aware of the guideline vs. those not aware of it, 61.6 vs 74.5 | 0.04 | |
Respiratory therapy does not respond promptly to mini-BAL orders for ICU patients with suspected VAP | Participants aware of the guideline vs. those not aware of it, 51.54 vs 41.3 | 0.05 | |
Pharmacy intervention in antibiotic ordering leads to effective ICU VAP management | Pharmacists vs. respiratory therapists, 50.5 vs 86.2, | <.01 | |
Nurses vs. respiratory therapists, 67.8 vs 86.2, | 0.04 | ||
Multidisciplinary management of patients occurs on their ICU | Pharmacists vs. respiratory therapists, 63.8 vs 88.1 | 0.04 | |
Pharmacists on their ICU effectively monitor antibiotic use | Pharmacists vs. respiratory therapists, 50.1 vs 82.9 | <.01 | |
Technology and its use | Having an electronic medical record (EMR) reduces the time necessary to diagnose VAP in the ICU | Physicians vs. nurses, 42.6 vs 75.9 | 0.04 |
Physicians vs. pharmacists, 42.6 vs 76.8 | 0.02 | ||
Use of clinically indicated tests | ICU respiratory therapists are capable of performing mini-BALs | *Participants aware of the guideline vs. those not aware of it, 63.8 | 0.03 |
ICU respiratory therapists are capable of performing mini-BALs | Respiratory therapists vs. pharmacists, 49.3 vs 84.2 | <.01 | |
More clinically useful specimens are collected when mini-BALs are performed | Respiratory therapists vs. physicians, 49.3 vs 91.1 | <.01 | |
Variation in practice | There is variation in VAP management depending on what service the ICU patient was on | Pharmacists vs. respiratory therapists, 47.9 vs 84.3 | <.01 |
There is variation in VAP management depending on who the VAP patient’s attending physician was | Pharmacists vs. respiratory therapists, 52.3 vs 79.8 | <.01 | |
There is variation in VAP management between attending physicians and house staff in the ICU | Pharmacists vs. respiratory therapists44.2 vs 75.5 | <.01 | |
Pharmacists vs. nurses, 44.2 vs 76.0 | <.01 | ||
Antibiotic ordering practices vary between house staff and attending physicians in the ICU | Respiratory therapists vs. pharmacists, 33.7 vs 63.2 | 0.02 | |
Respiratory therapists vs. physicians, 33.7 vs 64.3 | |||
Respiratory therapists vs. physicians, 33.7 vs 64.3 | 0.03 | ||
Nurses vs. pharmacists, 45.0 vs 63.2 | 0.04 |