Nurses' Knowledge on Ventilator-Associated Pneumonia: A Systematic Review and Meta-Analysis

Background: Mechanically ventilated patients are at risk of developing the iatrogenic infection ventilator-associated pneumonia (VAP). Inadequate knowledge of nurses is one of the obstacles to adherence to evidence-based guidelines to prevent VAP. Objectives: This study aimed to estimate the knowledge of nurses about VAP prevention. Methods: In this systematic review and meta-analysis, national and international databases, including MagIran, Scientific Information Database (SID), Web of Sciences, PubMed, and Scopus were searched using the following keywords: "Ventilator-associated pneumonia", "VAP", "Nosocomial pneumonia", "Knowledge", and their possible combinations. The VAP prevention score was calculated according to the questionnaire introduced and validated by Labeau et al. The analyses were performed using Stata (version 12). Results: In the initial search, 1193 articles were found of which a total of 8 articles were included in the analysis. The nurses achieved 48.31% of the VAP prevention total score (Confidence Interval [CI]: 95%: 44.63- 52). The lowest and highest VAP prevention scores were attributed to frequency of humidifier changes (15.13%, CI: 95%: 11.35-18.92) and patient positioning (81.03%, CI: 95%: 75.43-86.64), respectively. The percentage of nurses' knowledge about VAP prevention in Asian studies was higher than that in the European studies (54.71% versus 44.92%). Conclusion: The nurses obtained less than half of the VAP prevention total score. Regular training courses and reviewing VAP prevention guidelines can keep nurses' knowledge up to date.