Using protocols to improve the outcomes of critically ill patients with infection: Focus on ventilator-associated pneumonia and severe sepsis

Translating the results of research into clinical practice in critically ill patients is a challenging endeavor and often a slow, complex process. The literature is replete with evidence-based guidelines for the prevention and treatment of infections in critically ill patients aimed to standardize care, reduce costs, and improve patient outcomes [1-4]. Despite the widespread publicity of such documents, non-adherence to guidelines is readily apparent and directly impacts patient morbidity and mortality [5-7]. Explanations for the lack of guideline adherence include disagreement with interpretation of clinical trials, limited evidence in support of specific pharmacologic or non-pharmacologic treatment strategies, and simply the hesitancy to change practices at the beside.