In Reply: In response to Dr Schultz and colleagues, there is evidence that ongoing support is required after a guideline is successfully implemented.1 Minimally, this support should be provided in the form of ongoing active reminders and educational interventions that are repeated at regular intervals. Ideally, the timing of the educational intervals should match the influx of new trainees. It is likely that ongoing adherence is improved as more interventions (such as timely performance feedback) are included in the ongoing support package.
Doig GS, Simpson F. Evidence-Based Nutrition Guidelines for Critically Ill Adults—Reply. JAMA. 2009;301(15):1542-1544. doi:10.1001/jama.2009.494