Effectiveness of educational programmes in preventing ventilator-associated pneumonia: a systematic review.

BACKGROUND: Ventilator-associated pneumonia (VAP) is the most frequent device-associated, nosocomial infection encountered in critical-care settings, associated with substantial morbidity, a two-fold increase in mortality rates and excess costs. According to previous studies, critical-care nurses' knowledge of and adherence to guidelines for preventing VAP is low in the absence of educational interventions. AIM: The aim of this study was to assess the current body of literature regarding the effectiveness of educational programmes, with a focus on learning and clinical outcomes, in order to identify ways to intensify current research. METHODS: Studies published between 2003 and 2012 contained in seven multi-disciplinary databases (Medline Ovid(®), the Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Scopus, Web of Science, Medic, and Academic Search Premier) were reviewed. A comprehensive literature search strategy was conducted in association with an information specialist. The study selection process was carried out by two researchers independently and objectively. FINDINGS: Eight original studies were included in the final review. Increasing the education of intensive care unit (ICU) personnel was linked to a significant improvement in the level of knowledge and adherence to guidelines and significant improvement in clinical outcomes, i.e. decreased incidence of VAP, length of ICU and hospital stays, mortality and costs. CONCLUSIONS: Education has significant benefits for improving patient safety, and thus the quality of care. Active implementation strategies involving repeated lectures and regular surveys of VAP occurrence would be beneficial. Further research is needed to design multi-centre, randomized, controlled, follow-up studies. Development of a universal method of outcome measurement is required to facilitate further evaluation of the relationship between educational programmes and clinical outcomes.