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Table 5 Comparisons of professional groups’ perceptions and beliefs about various items related to VAP management

From: Management of ventilator-associated pneumonia in intensive care units: a mixed methods study assessing barriers and facilitators to guideline adherence

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
  1. Note: Only statistically significant (Bonferroni corrected) pairwise comparisons are presented in this table
  2. A 5-point Likert scale used was as follows:1 strongly agree, 2 agree, 3 neither agree nor disagree, 4 disagree and 5 strongly disagree or 1 rarely, 2 occasionally, 3 sometimes, 4 fairly often and 5 very often. Therefore, a professional group with a smaller rank was more likely to believe or report the stated item than the professional group with a larger mean rank. The opposite is true for items with *
  3. EMR electronic medical record, VAP ventilator-associated pneumonia, ICU intensive care unit, mini-BAL mini-bronchoalveolar lavage