The Impact of Group Reflection on Preventive Behaviors for Ventilator-Associated Pneumonia Among ICU Nurses.

Abstract

Background: Reflection is a fundamental component of nursing education and professional practice. This study aimed to evaluate the impact of structured group reflection sessions on ICU nurses' adherence to Ventilator-Associated Pneumonia (VAP) prevention practices.

Materials and methods: This quasiexperimental study a total of 44 ICU nurses from Namazi Hospital in Shiraz, Iran, participated. Two ICUs were randomly selected. The intervention consisted of four group reflection sessions, each comprising 7-8 participants, conducted over 2 weeks and guided by VAP prevention protocols. Nurses' performance was assessed before the intervention and at 1, 4, and 8 weeks afterward using the Behesht Aeen checklist. Data were analyzed using SPSS v. 16.

Results: The findings revealed that the intervention group demonstrated a significant improvement and an upward trajectory in all dimensions of nurses' performance across the postintervention follow-up periods (p < 0.001). In sharp contrast, the control group's performance remained stable across all time points (p > 0.05) for all dimensions, with the sole exception being endotracheal tube protection. One week after the intervention, the control group scored 18.13 (5.30), whereas the intervention group scored 28.59 (1.65) (t₄₂= -12.64, p < 0.001(. This divergence was maintained at 4 weeks, with scores of 17.22 (3.71) for the control group and 30.00 (1.77) for the intervention group (U₄₂ = 00.00, p < 0.001(. At eight weeks later, the scores were 15.86 (3.94) for the control group and 29.31 (1.49) for the intervention group (U₄₂ = 00.00, p < 0.01).

Conclusions: The findings indicate that structured group reflection sessions are an effective educational strategy to enhance ICU nurses' preventive behaviors for VAP, thereby improving clinical performance and quality of care.