Table 2.
Survey results for attitude toward and perceived barriers to low-Vt ventilation
| Item | Response | Physicians, Mean (SD) | Nurses, Mean (SD) | Respiratory Therapists, Mean (SD) |
|---|---|---|---|---|
| Attitude toward low-Vt ventilation | ||||
| What percentage of your patients with ARDS warrant treatment with LTVV based on the best available evidence? | Percentage as continuous variable | 92.5% (15.3%) | 61.1% (29.5%)* | 67.8% (26.8%)* |
| What percentage of your patients with ARDS have contraindications to receiving LTVV? | Percentage as continuous variable | 7.8% (9.6%) | 24.8% (20.4%)* | 20.5% (17.8%)* |
| Response | Physicians (n [%]) | Nurses (n [%]) | Respiratory Therapists (n [%]) | |
|---|---|---|---|---|
| Attitude toward LTVV ventilation | ||||
| How strong do you believe the evidence is that your patients with ARDS will benefit from LTVV? | Very strong or strong | 80 (96.4) | 195 (66.6)* | 60 (77.9)* |
| In your opinion, how large is the benefit of LTVV in reducing mortality for your ARDS patients? | Very large or large | 56 (67.5) | 146 (50.9)* | 41 (54.0) |
| Level of agreement or disagreement: I will only order/administer [nurses/respiratory therapists: administer] LTVV if I am certain my patient has ARDS. | Strongly disagree or disagree | 67 (80.7) | 78 (26.7)* | 28 (36.8)* |
| Perceived barriers to LTVV | ||||
| Level of agreement or disagreement: It is easy for me to obtain all the information I need to determine whether a patient has ARDS. | Strongly agree or agree | 72 (87.8) | 189 (66.3)* | 63 (81.8)† |
| Level of agreement or disagreement: It is easy to make sure a patient is receiving LTVV. | Strongly agree or agree | 70 (86.4) | 230 (81.6) | 68 (88.3) |
| Level of agreement or disagreement: It is easy to order [nurses/respiratory therapists: initiate and administer] LTVV. | Strongly agree or agree | 75 (91.5) | 214 (76.4)* | 68 (89.5)† |
| How long does it usually take from the time a patient clinically develops ARDS to the time you receive all the information needed to make a diagnosis of ARDS? | Less than 6 h or 6 h to just under 12 h | 71 (86.6) | 189 (67.0)* | 52 (68.4)* |
| How often issue delays diagnosis of ARDS or decision to treat with LTVV: obtaining a chest radiograph and being notified of the results. | Never or rarely | 66 (80.5) | — | — |
| How often issue delays diagnosis of ARDS or decision to treat with LTVV: obtaining an arterial blood gas and being notified of the results. | Never or rarely | 68 (82.9) | — | — |
| How often issue delays diagnosis of ARDS or decision to treat with LTVV: finding time to review all the patient’s records and decide whether to make a diagnosis of ARDS. | Never or rarely | 50 (61.0) | — | — |
| How often issue delays diagnosis of ARDS or decision to treat with LTVV: not promptly recognizing that a patient has ARDS even when all data are available and the criteria appear to be met. | Never or rarely | 55 (67.1) | — | — |
| How often issue delays diagnosis of ARDS or decision to treat with LTVV: the time from ordering LTVV to your patient receiving it. | Never or rarely | 53 (64.6) | — | — |
Definition of abbreviations: ARDS = acute respiratory distress syndrome; LTVV = low-Vt ventilation.
P < 0.017 for comparison with physicians.
P < 0.017 for comparison with nurses.