Factors influencing nurses’ adherence to ventilator-associated pneumonia prevention bundles: a scoping review
DOI:
https://doi.org/10.62741/ahrj.v3i2.148Keywords:
Critical care nursing, Patient Care Bundles, Guideline adherence, Pneumonia Ventilator-Associated, Disease preventionAbstract
Introduction: Ventilator-associated pneumonia is a healthcare-associated infection with a significant impact on morbidity, mortality, length of stay, and hospital costs in intensive care units. Nurses’ adherence to prevention bundles plays a key role in the effectiveness of these interventions, although it is influenced by multiple factors.
Objective: To map the available scientific evidence on the factors influencing nurses’ adherence to ventilator-associated pneumonia prevention bundles in intensive care units.
Methodology: Scoping review conducted in accordance with the Joanna Briggs Institute methodology and PRISMA-ScR. Eligibility criteria were defined according to the PCC framework (Participants – nurses providing care to patients undergoing mechanical ventilation in the ICU; Concept – studies addressing nurses’ adherence or non-adherence to ventilator-associated pneumonia prevention bundles, as well as factors associated with their implementation; Context – studies conducted in intensive care units or equivalent hospital settings providing care to critically ill patients receiving invasive mechanical ventilation). Studies published in Portuguese, English, and Spanish were included, identified through the MEDLINE Complete (via PubMed), CINAHL Complete, MedicLatina, and Cochrane Central Register of Controlled Trials (via EBSCOhost) databases, and selected by two independent reviewers, with a third reviewer involved in cases of disagreement. The search was conducted in March 2026.
Results: Five core categories were identified: team training and capacity building; implementation strategies and practice monitoring; institutional resources and organizational conditions; professional and organizational factors; and clinical outcomes and care indicators. Continuous training, audit and feedback, practice monitoring, availability of resources, and institutional support were found to promote adherence, whereas workload, staff turnover, communication failures, and resource shortages may hinder it.
Conclusion: Nurses’ adherence to ventilator-associated pneumonia prevention bundles is influenced by multiple and interdependent factors, reinforcing the importance of integrated strategies involving training, monitoring, and organizational support to promote safe, evidence-based practice.
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