A systematic review on the effectiveness of nurse-led ventilatorassociated pneumonia (VAP) prevention bundles and theirimpact on patient mortality rates in intensive care units

Abstract

Ventilator-associated pneumonia (VAP) remains one of the most serious healthcare-associated infections affecting critically ill patients receiving invasive mechanical ventilation in intensive care units (ICUs). Despite remarkable advances in intensive care practices, VAP continues to contribute significantly to prolonged hospitalisation, increased healthcare expenditure, higher antibiotic consumption, and elevated patient mortality. The present systematic review synthesises current evidence regarding the effectiveness of nurse-led VAP prevention bundles and their influence on important clinical outcomes. The review demonstrates that structured nurse-led preventive interventions consistently reduce VAP incidence by improving compliance with evidence-based infection prevention practices. The findings indicate that high adherence to ventilator care bundles, including head-of-bed elevation, oral hygiene, maintenance of endotracheal cuff pressure, subglottic secretion drainage, sedation interruption, spontaneous breathing trials, and strict hand hygiene, significantly decreases ventilator-associated infections. Several studies included in the review reported substantial reductions in VAP incidence, shorter duration of mechanical ventilation, decreased intensive care unit length of stay, reduced hospitalisation, and improvement in overall patient recovery. Greater compliance with nurse-led protocols was also associated with lower healthcare costs and decreased exposure to broadspectrum antimicrobial therapy. The review further highlights the pivotal role of critical care nurses in ensuring continuous surveillance, protocol adherence, patient assessment, and multidisciplinary coordination throughout the period of mechanical ventilation. The overall evidence supports nurse-led VAP prevention bundles as an effective, evidence-based strategy for improving patient safety and enhancing the quality of critical care services in intensive care units.