There is a story of an intensive care unit (ICU) at Dominican Hospital in Santa Cruz Country, California. Dominican, a 379-bed community hospital, is part of the 41-hospital Catholic Healthcare West system. "We used to replace ventilator circuit for incubated patients daily because we thought this helped to prevent pneumonia, " explained Lee Vanderpool, vice president. ""But the evidence shows that the more you interfere with that device, the more often you risk introducing infection. It turns out it is often better to leave it alone until it begins to become cloudy, or `gunky, ' as the no clinicians say." The hospital staff learned an important lesson from this experience that:
- Evidence is more powerful than intuition
- Intuition is more powerful than evidence
- Efforts improve mortality rate
- Introduction f a new protocol, or any new idea, involves education
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