Background Ventilator-associated pneumonia (VAP) poses a significant challenge in critical care settings, impacting
patient outcomes and healthcare costs. In Saudi Arabia, several studies have reported concerns regarding VAP,
including variable VAP rates, inconsistent compliance with and knowledge of VAP prevention practices, and
inadequate national data.
Objectives To investigate the intensive and critical care nurses’ (ICCNs) self-reported perceived compliance with
VAP prevention guidelines, barriers and challenges in caring for mechanically ventilated patients, the demographic
variables that associate compliance and factors affecting VAP prevention, and the association between perceived
compliance and the barriers affecting the care of mechanically ventilated patients.
Methods A descriptive, correlational, and cross-sectional design was used. ICCNs (n = 152) were conveniently
recruited from two tertiary government-owned hospitals. Data were collected using self-report scales from April to
June 2024. Descriptive and inferential statistics were used for data analyses.
Results Findings showed that 43% of ICCNs had high compliance with VAP prevention guidelines. The use of
protective gloves at every approach to a patient (96.70%) was the VAP guideline that received the highest perceived
compliance among ICCNs. Meanwhile, those with 11 to 15 years of experience were more compliant (p = 0.023) than
other groups and demographics. Major barriers to compliance included nursing staffing shortages (94.10%) and
limited resources (75.00%). Only ICCNs with 11 to 15 years of experience showed greater awareness of VAP prevention
guidelines (p = 0.023). Nurses’ nationality, i.e., non-Saudi nurses (p = 0.024) and higher educational levels (p = 0.005),
demonstrated greater awareness of barriers to managing and caring for mechanically ventilated patients. ICCNs perceived barriers negatively influenced their perceived compliance with VAP prevention (p = 0.002), indicating that
increased barriers are associated with lower compliance. Finally, the considerable challenges in VAP prevention were
time constraints and the need for more communication among the health team.
Conclusion Staffing shortages and resource limitations impacted ICCNs’ compliance with VAP prevention
guidelines. Furthermore, they became less compliant with higher VAP barrier perceptions. Time constraints and
team communication were considerable challenges in VAP prevention. As a result, nurse managers could create
comprehensive programs like long-term VAP prevention training and interdisciplinary collaboration in the ICU.
Healthcare organization administrators should enhance resource allocation and policy formulation to foster
compliance.