Nurses' compliance to ventilator-associated pneumonia prevention bundle and its effect on patient outcomes in intensive care units.
Fatma Al-Harthi, Huda Al-Noumani, Gerald Amandu Matua and 2 others
PMID 40276934WHAT IT FOUND
In 103 mechanically ventilated ICU patients, nurses fully complied with the seven-element VAP bundle 69% of the time.
Compliance dropped from 90% on day one to 60% by day 30. Higher compliance correlated with shorter stays, fewer ventilator days, and lower costs.
Key findings
01Nurses fully complied with the VAP care bundle for 69% of patients, but compliance declined from 90% on day one to 60% on day 30.
02Higher nurse compliance with the VAP bundle was significantly associated with shorter length of stay, fewer mechanical ventilation days, and lower hospital costs.
03Patients who developed ventilator-associated pneumonia had significantly lower mean nurse compliance scores (56.6) compared to those who did not (72.9).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was conducted in only two tertiary hospitals in Oman, which may limit the generalizability of the findings to other settings or patient populations. The observational design restricts the ability to establish a cause-and-effect relationship between nurse compliance and patient outcomes; it shows association, not proof that compliance alone caused the improvements. The sample size was relatively small (103 patients) and the follow-up period was brief (six months), which may affect the stability of the VAP rate estimates. Hospital costs were estimated using a fixed average daily cost (LOS x 45 OMR) rather than itemized billing data, which may not accurately reflect the true resource utilization or cost savings for individual patients.
Declared interests
The authors declared no known competing interests or relationships.
The easy way to misread this
Do not interpret the association between compliance and reduced length of stay or costs as proof that increasing compliance alone will cause these outcomes. The study is observational, so patients who received higher compliance may have differed in other ways not measured, such as severity of illness or physician management, which could also influence recovery time and cost.