Adult intensive care unit nurses' knowledge of and compliance barriers to evidence-based guidelines for prevention of ventilator-associated pneumonia: A cross-sectional survey.

Background: Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in intensive care units (ICUs) and is a common cause of morbidity and mortality in intensive care patients. Previous studies show that insufficient knowledge and compliance barriers among nurses affect pneumonia. There have been no investigations into intensive care nurses' knowledge and compliance barriers to evidence-based guidelines (EBGs) for VAP prevention in county-level hospitals in China.

Aim: To explore adult ICU nurses' knowledge and compliance barriers to EBGs for preventing VAP in county-level hospitals in Hunan Province, China, examine the correlation between knowledge and compliance barriers, and analyse associated factors.

Study design: A cross-sectional electronic survey was conducted to focus on nurses' knowledge of and compliance barriers to EBGs for preventing VAP.

Results: A total of 386 valid questionnaires were collected, with a response rate of 97.47% (386/396 = 97.47%). The median scores for nurses' knowledge (out of 9) and compliance barriers (out of 8) to EBGs for preventing VAP were 7 (interquartile range: 5-8) and 3 (interquartile range: 2-4), respectively. Knowledge was negatively associated with compliance barriers (r = -0.437, p < .01). The results of the multiple linear regression analysis showed that hospital level, age, nurses' attendance at VAP training and years of experience in ICUs were related to the level of knowledge. Nurses' attendance at VAP training, age and years of experience in ICUs were associated with the level of compliance barriers.

Conclusions: Intensive care nurses have satisfactory knowledge of EBGs for preventing VAP, but compliance barriers can be reduced. Better knowledge helps reduce the barriers to compliance among nurses.

Relevance to clinical practice: Nurse managers and nurse educators are suggested to examine nurses' knowledge and compliance barriers to EBGs for preventing VAP, develop personalized training plans, promote continuous education based on the latest EBGs and raise the nurse-patient ratio reasonably.