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Erschienen in:

01.08.2008 | Original

Bedside adherence to clinical practice guidelines in the intensive care unit: the TECLA study

verfasst von: Jean-Pierre Quenot, Hervé Mentec, François Feihl, Djillali Annane, Christian Melot, Philippe Vignon, Christian Brun-Buisson, TECLA Study Group

Erschienen in: Intensive Care Medicine | Ausgabe 8/2008

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Abstract

Objective

To assess adherence to clinical practice guidelines for three interventions routinely used in critical care medicine.

Design and setting

Multicenter, 1-day cross-sectional observational study in 44 intensive care units in four countries.

Patients

A total of 419 patients hospitalized in participating ICUs on the day of the survey.

Measurements and results

Red blood cell transfusion (n = 29) was performed appropriately in 22 patients (76%), while among the 390 patients who received no transfusion 4 (1%) had a valid indication. Setting of tidal volume in acute respiratory distress syndrome, assessed in 45 patients, was deemed appropriate in 37 cases (82%). Prescription of stress ulcer prophylaxis (n = 128) was appropriate in only 24 patients (19%), while among the 268 patients who were not treated 28 (10%) had an indication.

Conclusions

The implementation of recommendations varies across different domains of care. While the adherence to current recommendations in routine practice is acceptable as regards tidal volume settings in acute respiratory distress syndrome, it is suboptimal for blood transfusion and prevention of upper gastrointestinal bleeding. Practice surveys are useful to inform strategies currently developed to assess practices of health-care professionals and develop strategies for more effective dissemination of medical knowledge.

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Titel: Bedside adherence to clinical practice guidelines in the intensive care unit: the TECLA study
verfasst von: Jean-Pierre Quenot
Hervé Mentec
François Feihl
Djillali Annane
Christian Melot
Philippe Vignon
Christian Brun-Buisson
TECLA Study Group
Publikationsdatum: 01.08.2008
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 8/2008
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1059-y

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Bedside adherence to clinical practice guidelines in the intensive care unit: the TECLA study