Knowledge, adherence, and barriers towards ventilator-associated pneumonia prevention among critical care nurses in Baoshan, the People’s Republic of China

Abstract

Ventilator-associated pneumonia (VAP) is the most common complication found among patients who use mechanical ventilation as a life support measure. To improve the quality of nursing practice related to VAP prevention, baseline information regarding knowledge, adherence, and barriers related to VAP prevention among critical care nurses should be explored. This descriptive correlation research was used to explore knowledge, adherence, and barriers towards VAP prevention among critical care nurses. The relationship between knowledge and adherence was also determined. Purposive sampling was used to recruit 142 critical care nurses from six hospitals in Baoshan City, Yunnan province, the People’s Republic of China. Measurement tools were composed of 1) a demographic data record form, 2) a questionnaire related to knowledge towards prevention of VAP (QKVAP), and 3) a questionnaire on VAP prevention compliance and barriers (QVAPCB). The Chinese versions of these instruments were used, and the tools’ quality was checked. The KR-20 score of the QKVAP was 0.81, and the Cronbach's alpha coefficients of the QVAPCB was 0.87. Data were analyzed using descriptive statistics and Spearman's rank-order correlation test. The results of this study were as follows: 1. participants' knowledge towards VAP was at a fair level with a mean score of 22.08 (SD = 3.31); 2. participants perceived adherence to VAP prevention was at a sufficient level, with a mean score of 36.83 (SD = 3.23); 3. there was a positive low correlation between knowledge and adherence to VAP prevention (r = .255, p < .001); and 4. the top three barriers towards VAP prevention among critical care nurses were staff shortages in the unit (M = 2.91, SD = 0.61); forgetfulness to perform some evidence- based procedures may increase the risk of VAP (M=2.91, SD= 0.46), and patients don't cooperate when performing some procedures to decrease VAP (M = 2.55, SD = 0.65).

Further research should be done to explore factors influencing adherence to and barriers towards VAP prevention in each ICU so that strategies to improve VAP prevention practices can be planned for accordingly. Moreover, intervention studies for improvement of knowledge and adherence of VAP prevention among critical care nurses should be designed and tested for their effectiveness.