Compliance of nursing staff with ventilator-associated pneumonia (VAP) prevention bundle: A literature review

Background: Ventilator-Associated Pneumonia (VAP) is one of the most common hospital-acquired infections, related with increased morbidity indicators. The implementation of care bundles can significantly reduce the incidence of VAP leading  to higher quality of care provided.

Aim: The investigation of the compliance rate of nursing staff with VAP prevention bundle.                                                                                                                                                                             

Methods: Search was performed on PubMed (April 06,2021) with the keywords: “nurse*”, “nursing staff”, “compliance”, “ventilator-associated pneumonia” and “VAP”, without time limit for the publication of scientific papers. Keywords were searched in the title and abstract of the studies. Studies were excluded if they were not published in English language, were conducted on animals and were case studies, editorials and letters to the editor.

Results: Of the scientific papers retrieved, 6 were included in the systematic review. In the majority of studies, the following care bundle for VAP prevention was implemented: 1) elevation of the head of the bed to 30°-45°, 2) performance of spontaneous breathing trials with sedatives turned off, 3) stress ulcer prophylaxis, 4) thromboembolism prophylaxis and 5) regular oral care with chlorhexidine. The compliance rate of nursing staff with VAP prevention bundle ranged from 5% to 87%.

Conclusions: There is a great variability in compliance rate of nursing staff with the VAP prevention bundle. Low compliance with VAP prevention bundles can lead to increased healthcare costs and low quality of healthcare.

Keywords: Nursing staff, prevention bundle, ventilator-associated pneumonia