Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study

Abstract Background Ventilator-associated pneumonia (VAP) poses a significant challenge in critical care settings, impacting patient outcomes and healthcare costs. In Saudi Arabia, several studies have reported concerns regarding VAP, including variable VAP rates, inconsistent compliance with and kn...

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Main Authors: Hazel Novela Villagracia, Tahani Nasser Alhejaili, Bushra Alshammari, Salwa Abd El Gawad Sallam, Awatif Mansour Alrasheeday, Lea L. Dando, Odeta A. Nacubuan, Habib Alrashedi, Shaimaa Mohamed Nageeb, Larry Terence O. Cornejo, Rico William A. Villagracia, Soha Kamel Mosbah Mahmoud, Ingrid Jacinto-Caspillo, Rizal Angelo N. Grande, Daniel Joseph E. Berdida, Bahia Galal Abd Elrazik Siam
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Nursing
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Online Access:https://doi.org/10.1186/s12912-025-03601-z
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author Hazel Novela Villagracia
Tahani Nasser Alhejaili
Bushra Alshammari
Salwa Abd El Gawad Sallam
Awatif Mansour Alrasheeday
Lea L. Dando
Odeta A. Nacubuan
Habib Alrashedi
Shaimaa Mohamed Nageeb
Larry Terence O. Cornejo
Rico William A. Villagracia
Soha Kamel Mosbah Mahmoud
Ingrid Jacinto-Caspillo
Rizal Angelo N. Grande
Daniel Joseph E. Berdida
Bahia Galal Abd Elrazik Siam
author_facet Hazel Novela Villagracia
Tahani Nasser Alhejaili
Bushra Alshammari
Salwa Abd El Gawad Sallam
Awatif Mansour Alrasheeday
Lea L. Dando
Odeta A. Nacubuan
Habib Alrashedi
Shaimaa Mohamed Nageeb
Larry Terence O. Cornejo
Rico William A. Villagracia
Soha Kamel Mosbah Mahmoud
Ingrid Jacinto-Caspillo
Rizal Angelo N. Grande
Daniel Joseph E. Berdida
Bahia Galal Abd Elrazik Siam
author_sort Hazel Novela Villagracia
collection DOAJ
description Abstract Background Ventilator-associated pneumonia (VAP) poses a significant challenge in critical care settings, impacting patient outcomes and healthcare costs. In Saudi Arabia, several studies have reported concerns regarding VAP, including variable VAP rates, inconsistent compliance with and knowledge of VAP prevention practices, and inadequate national data. Objectives To investigate the intensive and critical care nurses’ (ICCNs) self-reported perceived compliance with VAP prevention guidelines, barriers and challenges in caring for mechanically ventilated patients, the demographic variables that associate compliance and factors affecting VAP prevention, and the association between perceived compliance and the barriers affecting the care of mechanically ventilated patients. Methods A descriptive, correlational, and cross-sectional design was used. ICCNs (n = 152) were conveniently recruited from two tertiary government-owned hospitals. Data were collected using self-report scales from April to June 2024. Descriptive and inferential statistics were used for data analyses. Results Findings showed that 43% of ICCNs had high compliance with VAP prevention guidelines. The use of protective gloves at every approach to a patient (96.70%) was the VAP guideline that received the highest perceived compliance among ICCNs. Meanwhile, those with 11 to 15 years of experience were more compliant (p = 0.023) than other groups and demographics. Major barriers to compliance included nursing staffing shortages (94.10%) and limited resources (75.00%). Only ICCNs with 11 to 15 years of experience showed greater awareness of VAP prevention guidelines (p = 0.023). Nurses’ nationality, i.e., non-Saudi nurses (p = 0.024) and higher educational levels (p = 0.005), demonstrated greater awareness of barriers to managing and caring for mechanically ventilated patients. ICCNs perceived barriers negatively influenced their perceived compliance with VAP prevention (p = 0.002), indicating that increased barriers are associated with lower compliance. Finally, the considerable challenges in VAP prevention were time constraints and the need for more communication among the health team. Conclusion Staffing shortages and resource limitations impacted ICCNs’ compliance with VAP prevention guidelines. Furthermore, they became less compliant with higher VAP barrier perceptions. Time constraints and team communication were considerable challenges in VAP prevention. As a result, nurse managers could create comprehensive programs like long-term VAP prevention training and interdisciplinary collaboration in the ICU. Healthcare organization administrators should enhance resource allocation and policy formulation to foster compliance. Clinical trial number Not applicable.
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institution Kabale University
issn 1472-6955
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publishDate 2025-07-01
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series BMC Nursing
spelling doaj-art-1d798ada75c84b08bf6aade4190ec3662025-08-20T04:01:53ZengBMCBMC Nursing1472-69552025-07-0124111310.1186/s12912-025-03601-zIntensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional studyHazel Novela Villagracia0Tahani Nasser Alhejaili1Bushra Alshammari2Salwa Abd El Gawad Sallam3Awatif Mansour Alrasheeday4Lea L. Dando5Odeta A. Nacubuan6Habib Alrashedi7Shaimaa Mohamed Nageeb8Larry Terence O. Cornejo9Rico William A. Villagracia10Soha Kamel Mosbah Mahmoud11Ingrid Jacinto-Caspillo12Rizal Angelo N. Grande13Daniel Joseph E. Berdida14Bahia Galal Abd Elrazik Siam15Medical-Surgical Nursing Department, College of Nursing, University of Ha’ilNursing Leadership Department, College of Nursing, University of Ha’ilMedical-Surgical Nursing Department, College of Nursing, University of Ha’ilMedical-Surgical Nursing Department, College of Nursing, University of Ha’ilNursing Administration Department, College of Nursing, University of Ha’ilMedical-Surgical Nursing Department, College of Nursing, University of Ha’ilPsychiatric and Mental Health Nursing Department, College of Nursing, University of Ha’ilMedical-Surgical Nursing Department, College of Nursing, University of Ha’ilPsychiatric and Mental Health Nursing Department, College of Nursing, University of Ha’ilPsychiatric and Mental Health Nursing Department, College of Nursing, University of Ha’ilMedical-Surgical Nursing Department, College of Nursing, University of Ha’ilCommunity Health Nursing Department, Faculty of Nursing, Benha UniversityMedical Surgical Nursing Department, College of Nursing, Northern Border UniversityNursing Department, Fakeeh College for Medical SciencesNursing Department, North Private College of NursingMedical-Surgical Nursing Department, College of Nursing, University of Ha’ilAbstract Background Ventilator-associated pneumonia (VAP) poses a significant challenge in critical care settings, impacting patient outcomes and healthcare costs. In Saudi Arabia, several studies have reported concerns regarding VAP, including variable VAP rates, inconsistent compliance with and knowledge of VAP prevention practices, and inadequate national data. Objectives To investigate the intensive and critical care nurses’ (ICCNs) self-reported perceived compliance with VAP prevention guidelines, barriers and challenges in caring for mechanically ventilated patients, the demographic variables that associate compliance and factors affecting VAP prevention, and the association between perceived compliance and the barriers affecting the care of mechanically ventilated patients. Methods A descriptive, correlational, and cross-sectional design was used. ICCNs (n = 152) were conveniently recruited from two tertiary government-owned hospitals. Data were collected using self-report scales from April to June 2024. Descriptive and inferential statistics were used for data analyses. Results Findings showed that 43% of ICCNs had high compliance with VAP prevention guidelines. The use of protective gloves at every approach to a patient (96.70%) was the VAP guideline that received the highest perceived compliance among ICCNs. Meanwhile, those with 11 to 15 years of experience were more compliant (p = 0.023) than other groups and demographics. Major barriers to compliance included nursing staffing shortages (94.10%) and limited resources (75.00%). Only ICCNs with 11 to 15 years of experience showed greater awareness of VAP prevention guidelines (p = 0.023). Nurses’ nationality, i.e., non-Saudi nurses (p = 0.024) and higher educational levels (p = 0.005), demonstrated greater awareness of barriers to managing and caring for mechanically ventilated patients. ICCNs perceived barriers negatively influenced their perceived compliance with VAP prevention (p = 0.002), indicating that increased barriers are associated with lower compliance. Finally, the considerable challenges in VAP prevention were time constraints and the need for more communication among the health team. Conclusion Staffing shortages and resource limitations impacted ICCNs’ compliance with VAP prevention guidelines. Furthermore, they became less compliant with higher VAP barrier perceptions. Time constraints and team communication were considerable challenges in VAP prevention. As a result, nurse managers could create comprehensive programs like long-term VAP prevention training and interdisciplinary collaboration in the ICU. Healthcare organization administrators should enhance resource allocation and policy formulation to foster compliance. Clinical trial number Not applicable.https://doi.org/10.1186/s12912-025-03601-zCritical care nursingComplianceHealthcare barriersIntensive care unitsVAP preventionVentilator-associated pneumonia
spellingShingle Hazel Novela Villagracia
Tahani Nasser Alhejaili
Bushra Alshammari
Salwa Abd El Gawad Sallam
Awatif Mansour Alrasheeday
Lea L. Dando
Odeta A. Nacubuan
Habib Alrashedi
Shaimaa Mohamed Nageeb
Larry Terence O. Cornejo
Rico William A. Villagracia
Soha Kamel Mosbah Mahmoud
Ingrid Jacinto-Caspillo
Rizal Angelo N. Grande
Daniel Joseph E. Berdida
Bahia Galal Abd Elrazik Siam
Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study
BMC Nursing
Critical care nursing
Compliance
Healthcare barriers
Intensive care units
VAP prevention
Ventilator-associated pneumonia
title Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study
title_full Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study
title_fullStr Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study
title_full_unstemmed Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study
title_short Intensive and critical care nurses’ compliance, barriers, and challenges with ventilator-associated pneumonia prevention: a cross-sectional study
title_sort intensive and critical care nurses compliance barriers and challenges with ventilator associated pneumonia prevention a cross sectional study
topic Critical care nursing
Compliance
Healthcare barriers
Intensive care units
VAP prevention
Ventilator-associated pneumonia
url https://doi.org/10.1186/s12912-025-03601-z
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