The Use of Clinical Practise Guidelines for Community-Acquired Pneumonia in Hospitals in Atlantic Canada

BACKGROUND: Clinical practice guidelines (CPGs) have been shown to improve the care of patients presenting to hospital with community-acquired pneumonia (CAP) and are considered the ′standard of care′. The extent of adoption of CPGs in Canada is unclear.

OBJECTIVE: To determine the use of CPGs by hospitals in Atlantic Canada (Newfoundland, Nova Scotia, New Brunswick, Prince Edward Island).

METHODS: Telephone survey of all hospitals listed in the Canadian Medical Directory as being situated in Atlantic Canada. Hospitals were included if they had all three of the following: an emergency department, x-ray facilities and acute care inpatient beds.

RESULTS: Of 143 hospitals, 93 were included for analysis. Of these, 41 (44.1%) used CAP CPGs. Hospitals were less likely to be using CAP CPGs if they were smaller, rural or community hospitals, or if they did not have an intensive care unit. Of the four provinces, New Brunswick had the most hospitals using CAP CPGs (73.1%), while Newfoundland had the least (17.2%).

CONCLUSIONS: Although larger teaching hospitals are using CAP CPGs, the degree of adoption of CPGs in smaller hospitals in Atlantic Canada is low. Efforts to produce standard CPGs that can be adapted to different sites, as well as implementation strategies, are indicated.