01.08.2010 | Research | Ausgabe 4/2010 Open Access

Physicians' and nurses' opinions on selective decontamination of the digestive tract and selective oropharyngeal decontamination: a survey
- Zeitschrift:
- Critical Care > Ausgabe 4/2010
Electronic supplementary material
Competing interests
Authors' contributions
Introduction
Materials and methods
Study protocol
Study period
|
Oral hygiene
|
Oral paste
†
|
Suspension
¥
|
Cefotaxim*
|
---|---|---|---|---|
SDD
|
+
|
+
|
+
|
+
|
SOD
|
+
|
+
|
||
Standard care
|
+
|
Questionnaire development
Analysis
Results
Nurses
|
Physicians
|
Total
|
||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
1
st
|
2
nd
|
3
rd
|
P value
|
1
st
|
2
nd
|
3
rd
|
P value
|
1
st
|
2
nd
|
3
rd
|
P value
|
|
Response - no. (%)
|
372 (74)
|
339 (73)
|
313 (65)
|
85 (89)
|
89 (82)
|
79 (77)
|
||||||
Prior experience SDD - %
|
53
|
74
|
87
|
68
|
85
|
90
|
||||||
Effect SDD - no. (%)
|
||||||||||||
No effect
|
101 (33)
|
80 (26)
|
63 (22)
|
0.017
|
12 (14)
|
12 (14)
|
3 (4)
|
0.065
|
113 (29)
|
92 (23)
|
66 (18)
|
0.004
|
Decrease pneumonia
|
135 (43)
|
151 (49)
|
165 (58)
|
0.002
|
64 (75)
|
71 (80)
|
65 (84)
|
0.354
|
199 (50)
|
222 (56)
|
230 (68)
|
0.001
|
Increase resistance
|
68 (22)
|
68 (22)
|
48 (17)
|
0.209
|
14 (17)
|
19 (21)
|
21 (27)
|
0.247
|
82 (21)
|
87 (22)
|
69 (19)
|
0.624
|
Decrease resistance
|
24 (8)
|
21 (7)
|
25 (9)
|
0.672
|
11 (13)
|
13 (15)
|
14 (18)
|
0.640
|
35 (9)
|
34 (9)
|
39 (11)
|
0.524
|
Increase survival*
|
81 (26)
|
83 (27)
|
97 (34)
|
0.062
|
36 (42)
|
45 (51)
|
47 (61)
|
0.059
|
||||
Other
|
21 (7)
|
35 (11)
|
25 (9)
|
0.129
|
9 (11)
|
11 (12)
|
13 (17)
|
0.478
|
30 (8)
|
46 (12)
|
38 (11)
|
0.145
|
Median PRRM (IQR)
|
3.0 (0-25)
|
12.9 (0-25)
|
16.7 (0-28.5)
|
0.113
|
Expectations on SDD efficacy
Nurses
|
Physicians
|
|
---|---|---|
No idea
|
82
|
1
|
Better oral hygiene
|
39
|
-
|
Increase colonization Enterococci/other bacteriae
|
3
|
6
|
Decrease other infections (besides VAP)
|
15
|
10
|
Other infection pattern
|
-
|
2
|
More frequent growth of yeasts
|
13
|
3
|
Less frequent growth of yeasts
|
2
|
-
|
Decrease length of stay
|
6
|
9
|
Increase length of stay
|
-
|
1
|
Better bacterial monitoring/antibiotics regimen
|
2
|
3
|
Increase diarrhea/change intestinal flora
|
3
|
-
|
Decrease multi organ failure
|
1
|
-
|
Decrease complications
|
-
|
1
|
Increase complications(wrong application)
|
-
|
1
|
Decrease morbidity
|
-
|
1
|
Decrease mechanical ventilation
|
-
|
2
|
Self-reported compliance to protocol
SDD
|
SOD
|
Standard care
|
P value
|
|
---|---|---|---|---|
Extra time in minutes
‡ - median (IQR)
|
5.0 (2-5)
|
3.0 (0-5)
|
3.0 (0-5)
|
0.000
|
Problems
‡ - % of times reported
|
79
|
74
|
||
- Patient disliked taste of oral paste - %
|
48
|
44
|
0.336
|
|
- Patient disliked suspension - %
|
22
|
--
|
--
|
|
- Patient was nauseous - %
|
17
|
9
|
0.003
|
|
- Patient found oral care annoying - %
|
54
|
58
|
0.318
|
|
- Patient did not cooperate with oral care - %
|
37
|
34
|
0.377
|
|
Change in application Orabase
‡ - %
|
31
|
29
|
0.305
|
|
- once not given - %
|
14
|
12
|
||
- given at another time - %
|
2
|
4
|
||
- discontinued - %
|
7
|
8
|
||
- other - %
|
8
|
5
|
Time needed for oral care
Grades for perceived workload and patient friendliness
N
|
SDD
|
SOD
|
Standard care
|
P value
|
|
---|---|---|---|---|---|
median (IQR)
|
median (IQR)
|
median (IQR)
|
|||
Nurses
|
|||||
Workload
a
|
207
|
5.0 (4.0-7.0)
|
4.0 (3.0-6.0)
|
2.0 (1.0-4.0)
|
0.000
|
Pt friendliness
b
|
197
|
4.0 (2.0-5.0)
|
4.0 (3.0-6.0)
|
7.0 (3.0-9.0)
|
0.000
|
Physicians
|
|||||
Workload
a
|
30
|
5.5 (3.8-7.0)
|
5.0 (3.0-6.0)
|
2.5 (2.0-4.0)
|
0.000
|
Pt friendliness
b
|
27
|
6.0 (4.0-7.0)
|
6.0 (4.0-6.0)
|
8.0 (6.0-9.0)
|
0.003
|