• Miia Jansson, Tero Ala-Kokko, Pekka Ylipalosaari, Hannu Syrjälä, and Helvi Kyngäs.
• Institute of Health Science, University of Oulu, Finland. miiajans@mail.student.oulu.fi
• Intensive Crit Care Nurs. 2013 Aug 1;29(4):216-27.

ObjectivesTo explore critical care nurses' knowledge of, adherence to and barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia.DesignA quantitative cross-sectional survey.MethodsTwo multiple-choice questionnaires were distributed to critical care nurses (n=101) in a single academic centre in Finland in the autumn of 2010. An independent-samples t-test was used to compare critical care nurses' knowledge and adherence within different groups. The principles of inductive content analysis were used to analyse the barriers towards evidence-based guidelines for prevention of ventilator-associated pneumonia.ResultsThe mean score in the knowledge test was 59.9%. More experienced nurses performed significantly better than their less-experienced colleagues (p=0.029). The overall, self-reported adherence was 84.0%. The main self-reported barriers towards evidence-based guidelines were inadequate resources and disagreement with the results as well as lack of time, skills, knowledge and guidance.ConclusionThere is an ongoing need for improvements in education and effective implementation strategies.Clinical ImplicationsThe results could be used to inform local practice and stimulate debate on measures to prevent ventilator-associated pneumonia. Education, guidelines as well as ventilator bundles and instruments should be developed and updated to improve infection control.Copyright © 2013 Elsevier Ltd. All rights reserved.

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