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Critical Care
Published in: Critical Care 4/2010

Open Access 01-08-2010 | Research

Physicians' and nurses' opinions on selective decontamination of the digestive tract and selective oropharyngeal decontamination: a survey

Authors: Irene P Jongerden, AnneMarie G de Smet, Jan A Kluytmans, Leo F te Velde, Paul J Dennesen, Ronald M Wesselink, Martijn P Bouw, Rob Spanjersberg, Diana Bogaers-Hofman, Nardo J van der Meer, Jaap W de Vries, Karin Kaasjager, Mat van Iterson, Georg H Kluge, Tjip S van der Werf, Hubertus I Harinck, Alexander J Bindels, Peter Pickkers, Marc J Bonten

Published in: Critical Care | Issue 4/2010

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Abstract

Introduction

Use of selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) in intensive care patients has been controversial for years. Through regular questionnaires we determined expectations concerning SDD (effectiveness) and experience with SDD and SOD (workload and patient friendliness), as perceived by nurses and physicians.

Methods

A survey was embedded in a group-randomized, controlled, cross-over multicenter study in the Netherlands in which, during three 6-month periods, SDD, SOD or standard care was used in random order. At the end of each study period, all nurses and physicians from participating intensive care units received study questionnaires.

Results

In all, 1024 (71%) of 1450 questionnaires were returned by nurses and 253 (82%) of 307 by physicians. Expectations that SDD improved patient outcome increased from 71% and 77% of respondents after the first two study periods to 82% at the end of the study (P = 0.004), with comparable trends among nurses and physicians. Nurses considered SDD to impose a higher workload (median 5.0, on a scale from 1 (low) to 10 (high)) than SOD (median 4.0) and standard care (median 2.0). Both SDD and SOD were considered less patient friendly than standard care (medians 4.0, 4.0 and 6.0, respectively). According to physicians, SDD had a higher workload (median 5.5) than SOD (median 5.0), which in turn was higher than standard care (median 2.5). Furthermore, physicians graded patient friendliness of standard care (median 8.0) higher than that of SDD and SOD (both median 6.0).

Conclusions

Although perceived effectiveness of SDD increased as the trial proceeded, both among physicians and nurses, SOD and SDD were, as compared to standard care, considered to increase workload and to reduce patient friendliness. Therefore, education about the importance of oral care and on the effects of SDD and SOD on patient outcomes will be important when implementing these strategies.

Trial registration

ISRCTN35176830.
Appendix
Available only for authorised users
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Metadata
Title
Physicians' and nurses' opinions on selective decontamination of the digestive tract and selective oropharyngeal decontamination: a survey
Authors
Irene P Jongerden
AnneMarie G de Smet
Jan A Kluytmans
Leo F te Velde
Paul J Dennesen
Ronald M Wesselink
Martijn P Bouw
Rob Spanjersberg
Diana Bogaers-Hofman
Nardo J van der Meer
Jaap W de Vries
Karin Kaasjager
Mat van Iterson
Georg H Kluge
Tjip S van der Werf
Hubertus I Harinck
Alexander J Bindels
Peter Pickkers
Marc J Bonten
Publication date
01-08-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9180

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