Nurse's Knowledge regarding Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia

Ventilator-associated pneumonia (VAP) is a subset of hospital infections occurring 24 hours after intubation or mechanical ventilation. Considering the outcome of VAP, prevention is of a high importance in the care of patients who are being treated by mechanical ventilation. Thus, evidence-based guidelines have been published by researchers to prevent ventilator-associated pneumonia and can effectively reduce its incidence.
The purpose of this study was to review the knowledge on these evidence-based guidelines in prevention of ventilator-associated pneumonia.
This is a descriptive -analytical, cross-sectional study which used census sampling method. 171 nurses with bachelor and master degree participated in the study. To determine their knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia, a two-part questionnaire was used. The first part included demographic information including age, sex, nursing position title, university degree, working experience and years in the intensive care unit as well as ICU specifications such as type and number of beds and internet access. The second part had Labeau et al. questionnaire that consisted of 9 multiple-choice questions. Questionnaires were given to the participants during morning, afternoon and night shifts by a researcher in each ward. The response time was 15 minutes. After collecting the questionnaires, correct responses were calculated in percentage and the mean of total score was determined. In this study, evaluations and judgments were based on the mean of score. In order to analyze the data, descriptive statistics were used to estimate the frequency. Chi-square, t-test and ANOVA were used to examine the relationship between level of knowledge, demographic variables and characteristics of intensive care unit.
171 of 219 ICU nurses participated in this study and 48 patients were excluded due to vaccation at the time of sampling or unwillingness. Most of the study population was women (93.6%) with a Bachelor's Degree (94.7%) and nurse position title (89.5%).In this study, 59.9% of the nurses had not passed any ICU-specific training course. 42.7% of them were in ICU with more than 8 beds. The majority of them (40.4%) had between 1-5 years of working experience. Furthermore, the mean score of nine one-score questions equaled 4.63±1.708. The most wrong answers belonged to the questions about "ventilator set's replacement frequency" and "the moisturizer's replacement period". The most correct answers were about "choosing a semi-sitting position for reducing VAP". Mean of scores obtained by women was higher than men. The independent t-test showed no significant difference between the two groups (P=0.721). The mean score was higher in nurses with master degree and the ones who had passed specific ICU nursing courses than the ones who did not. Independent t-test manifested no significant difference (P=0.189, P=0.204) in this regard. Among the participants who had replacement nurse position, nurses working in ICUs with more than 8 beds and nurses with more than 10 years of experience had a higher mean score. Yet, ANOVA showed no significant difference among these groups (P =0.168, P=0.882, P=0.327).
This results in more attention to training purposes in some parts of the guidelines. Lack of nurse's knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia is one of the potential barriers and increasing the awareness level will be the first step in a successful training program.
The findings seem to highlight the importance of specific parts of the guidelines that should be considered in trainings. Lack of nurse's knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia is one of the potential barriers. Increasing their awareness will be the first step for a successful training program on VAP prevention.