Factors that promote nurses’ adherence to ventilator associated pneumonia prevention guidelines in critical care units of Bomet and Kericho Counties, Kenya

Abstract

Ventilator-associated pneumonia (VAP) is Bacterial pneumonia that develops in patients on mechanical ventilation within 48 to 72 hours Despite the availability of evidence-based standards, hospital critical care units have high rates of mortality and morbidity. Although evidence-based recommendations are successful in considerably lowering the incidence of VAP, nurses find it difficult to fully adhere to them. This study sought to assess the degree of adherence to ventilator-associated pneumonia care bundles in critical care units. A cross-sectional design was used in the study. Regression analysis was used to look for any connections between nurses' years of experience, educational attainment and compliance with IHI's VAP bundle components. The study showed there is a significant relationship between adherence of VAP and critical care patients (p=0.003) thus adherence of VAP bundles has significant relationship with critical care of patients. Use of Chlorhexidine (0.011), bed head elevation (p=0.002), spontaneous breathing trials (p=0.043) and peptic ulcer prevention (p=0.001) are all examples of how nurses follow the ventilator associated guidelines. However, the daily breathing trial adherence was negligible (p=0.172). According to the Institute of Healthcare Improvement's (IHI) guideline, complete adherence to ventilator Associated bundle elements was hampered by a lack of resources, including clean gloves, kinetic beds, closed suction equipment and ongoing education for nurses. For the VAP bundle recommendations to be fully implemented, the factors preventing nurses from doing so are reduced.