What are the factors that affect critical care nurse to implementing ventilators associated pneumonia care bundles? A Systematised Literature Review

Abstract

Abstract Background. Ventilator-associated pneumonia (VAP) is the most prevalent acquired hospital pneumonia in intensive care units (ICUs). Critical care nurses (CCNs) play a significant role in reducing errors and maintaining the accuracy of VAP diagnosis. Thus, CCNs hypothesised that by implementing VAP care bundles, nurse performance will positively affect patients' conditions. However, some factors influence nurses' application of VAP care bundles. Aim: The aim of this study was to answer the question, ‘What are the factors that influence critical care nurses in implementing VAP bundles?’ Methods: A mixed-method systematised literature review was conducted to answer the research question, which was formulated by using the PICO framework (population, intervention, comparison, and outcomes). The PsycINFO, Medline, Embase, and CINAHL databases were searched for primary research studies on intensive care nurses and ventilatorassociated pneumonia that were published in the English language within an unrestricted period. The ENDNOTEX9 software was used to analyse the complete selection, followed by assessment of the study quality using a quality assessment tool for reviewing studies with diverse designs. Results: Seven studies met the inclusion criteria, of which six were quantitative studies (crosssectional and survey studies) and one was a qualitative study (phenological study). CCNs highlighted the influencing factors, along with two main themes, namely level of knowledge and organisational factors. However, selection and result biases diminished the methodological quality in some studies. Overall, the related literature was of moderate quality. Conclusion: The present review answered the study question; however, further studies with high-quality evidence and large samples are needed. The limited literature and the importance of articles that describe nurses' experiences warrant additional qualitative studies. Dissemination: Internationally, Intensive & Critical Care Journal -peer-review journal and sharing in social Media platforms. Locally, Saudi Medical Journal and present the poster in hospital and in ICU.