From May 2003-2004, in a cluster-randomized trial of differing educational strategies, the Canadian Clinical Practice Guidelines (CPGs) were disseminated across 58 ICUs in Canada. The results showed that active dissemination of the CPGs improved certain nutrition practices and overall dissemination improved other important nutrition support practices but was not associated with improvements in clinical outcomes.Jain M, Heyland D et al CCM 2006;34:2362. For more details click here.

Barriers and Enablers to Guideline Adherence

Following the modest impact of the guideline dissemination Cluster RCT on clinical practice, we conducted a qualitative study to identify the barriers and enablers to adherence of the Canadian Critical Care Nutrition CPGs, and created a comprehensive framework for understanding factors associated with guideline adherence in the ICU. Our findings suggest that guideline adherence is profoundly complex and is determined by practitioner, patient, institutional and guideline factors. For more details click here.

We are currently conducting a feasibility study, entitled the PERFECTIS Study, to provide preliminary evidence of the logistics and feasibility of identifying barriers to adherence to key recommendations of the Canadian Critical Care Nutrition CPGs and tailoring guideline implementation strategies to overcome the identified barriers and improve adherence. For more information on this study, click here .