Evidence-based guidelines for the prevention of ventilator-associated pneumonia: knowledge, adherence and perceived barriers among nurses

Abstract

Background/Aims Ventilator-associated pneumonia is a common but avoidable healthcare-associated infection in intensive care units, leading to preventable deaths. The study aimed to assess the knowledge of, adherence to and barriers against evidence‑based guidelines for preventing ventilator-associated pneumonia among nurses at an intensive care unit in Palestine. Methods A cross-sectional study was conducted, using a convenience sampling method to recruit 250 intensive care nurses working in the southern region of Palestine. Data were collected using a self-administered questionnaire comprising four sections: sociodemographic characteristics; knowledge of ventilator-associated pneumonia prevention (scored as a %); adherence to evidence-based guidelines (scored as a %); and barriers to adherence (rated on a 5-point Likert scale). Independent t-tests, ANOVA and Pearson’s correlation were used to assess relationships between variables. Significance was set at P<0.05. Results Most participant had a moderate or low level of knowledge, while 61.2% reported good adherence to evidence-based guidelines for prevention of ventilator‑associated pneumonia. Significant positive relationships were found between adherence scores and experience working in intensive care (P=0.033) and knowledge scores and completion of specific infection-prevention training (P=0.034). Barriers with the highest mean scores were lack of knowledge, lack of educational programmes and lack of time. Conclusions Intensive care nurses may be lacking knowledge regarding evidence-based guidelines for the prevention of ventilator-associated pneumonia, leading to difficulties implementing these guidelines in practice. Adherence may improve with experience working in intensive care, but interventions are needed to improve nurses’ knowledge of infection prevention and ensure that this is translated to practice. Implications for practice Mentorship programmes should be implemented to enhance adherence to evidence-based guidelines in intensive care units. Incorporating guidelines for ventilator-associated pneumonia prevention into the nursing curriculum should also be considered, to ensure that all nurses are equipped for safe and effective practice.