Qualitative study on the behavior of nurses in relation to the prevention of pneumonia associated with mechanical ventilation within an intensive care unit

Abstract

Background: Ventilator-associated pneumonia (VAP) is a common challenge in intensive care units (ICUs) worldwide, responsible for major complications and adverse events impacting patient health and safety. Consequently, the quality of care is crucial for the prevention of VAP.

Participants and Research Context: This study describes nursing care in the Intensive Care Unit of the University Hospital of Cagliari, where interventions implemented by nursing staff for the prevention of VAP were observed.

Objective: To investigate the factors and nursing interventions in the ICU that significantly reduce the onset of VAP and to collect the outcomes emerging from the nursing interventions implemented by the staff, as well as from interviews conducted during the study period. This led to the identification of potential corrective actions aimed at significantly reducing VAP incidence rates.

Methods: A qualitative phenomenological approach was used, employing Interpretative Phenomenological Analysis (IPA), which highlights the personal opinions, training, and professional experiences of nurses in managing VAP prevention in ICU patients. The data collection tool was the individual semi-structured interview, the most commonly used method in IPA. Additionally, by comparing guidelines and scientific publications, a checklist was used, allowing for an objective assessment of the nursing staff's performance involved in the study through the use of surveillance cameras within the patient rooms.

Ethical Considerations: Participation in the study was voluntary, and all participants consented to the anonymous processing of their data.

Results and Conclusions: Among the solutions identified, the importance of continuous training for nursing staff in VAP prevention was noted, aiming to enhance the efficiency of nursing care for patients and the prevention of this issue. It was highlighted how nursing staff, in collaboration with medical personnel, could use assessment scales for the early diagnosis of VAP. The urgent need to improve certain care practices through increased staffing of updated and trained health professionals was recognized, ensuring comprehensive care management in preventing VAP. These results, compared with those already analyzed in the literature, demonstrate the significance of the nursing role and the interventions it carries out in preventing ventilator-associated pneumonia.