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Abstract
Background: Ventilator-associated pneumonia (VAP) is a common and serious nosocomial infection in intensive care units (ICUs), leading to increased morbidity, mortality, and healthcare costs. Nurses play a pivotal role in preventing VAP through adherence to evidence-based practices. Compliance with preventive guidelines is influenced by individual, educational, and organizational factors, while barriers such as staff shortages, lack of resources, and insufficient training may limit effective implementation. Understanding these factors is critical to improving patient outcomes and ICU care quality.
Aim: The study aimed to assess nurses’ compliance with VAP prevention guidelines and identify associated barriers in adult ICUs of public hospitals in Lahore, Pakistan.
Methods: A cross-sectional descriptive study was conducted among 115 nurses working in six public hospitals in Lahore. Data were collected using a structured, close-ended questionnaire covering demographic characteristics, compliance with 17 VAP prevention guidelines, and perceived barriers related to hospital policies, education, and nurse-related factors. Descriptive statistics, including frequencies and percentages, were used to summarize compliance, while inferential statistics analyzed associations between demographic factors, training, and adherence.
Results: High compliance was observed for basic practices such as hand hygiene (83.5%), glove use (86.1%), oral care (90.4%), and semi-Fowler positioning (86.1%). Lower compliance was noted for subglottic secretion suctioning (15.7%) and use of heat and moisture exchange humidifiers (53%). Major barriers included staff shortages (82.6%), unavailability of resources (67%), lack of continuous education (48.7%), and fear of adverse patient outcomes (56.5%). Nurses with prior training demonstrated better adherence to VAP prevention guidelines.
Conclusion: While basic preventive measures were well adhered to, specialized interventions showed lower compliance. Organizational, educational, and nurse-related barriers significantly impacted adherence. Structured training, adequate staffing, resource availability, and institutional support are essential to enhance compliance and reduce VAP incidence.