{
    "abstract": "Ventilator-associated pneumonia (VAP) is a frequent and severe complication among newborns in neonatal intensive care units (NICUs). It is associated with elevated morbidity and mortality rates, more extended hospital stays and increased health care costs. Implementing preventive care bundles and structured sets of evidence-based practices reduces VAP incidence. As primary caregivers, nurses are critical in consistently applying these preventive measures in NICU settings.\nTo evaluate the impact of a structured training programme on nurses' practices in the prevention of VAP among ventilated newborns in NICUs.\nThis prospective, pre- and post-intervention study was conducted with 27 nurses caring for mechanically ventilated newborns. All newborns admitted to the NICU who met inclusion criteria were included in the study (34 newborns pre-intervention, 38 newborns post-intervention and 41 newborns 3\u2009months after the intervention).\nThe results indicate significantly improved nurses' practices for VAP prevention across the core, equipment-related general measures, with total mean scores increasing from 50.67% (95% CI: 44.30-56.92) pre-programme to 89.26% (95% CI: 85.68-92.84) immediately post-programme and 73.33% (95% CI: 67.79-78.88) after 3\u2009months (p\u2009<\u2009.001). Before the programme, 85.3% of newborns developed VAP. However, this dropped dramatically to just 10.5% immediately after the programme, with a relative risk of 0.123 (95% CI: 0.046-0.328, p\u2009<\u2009.001). Even 3 months later, the rates remained much lower at 19.5% than before the programme, with a relative risk of 0.228 (95% CI: 0.117-0.445, p\u2009<\u2009.001). Multivariate logistic regression showed that only overall nurses' practices remained statistically significant in reducing VAP risk (OR\u2009=\u20090.819, 95% CI: 0.728-0.920, p\u2009=\u2009.001) after adjusting for confounders. Prolonged ventilation and individual components of nursing practices were not significant in the multivariate model.\nThis study demonstrates that a structured educational programme can significantly enhance nurses' adherence to VAP preventive practices and reduce VAP incidence. Regular training initiatives are crucial for sustaining high care standards, thereby improving neonatal patient health care outcomes.\nNewborns in the neonatal intensive care unit (NICU) are at a higher risk of developing ventilator-associated pneumonia (VAP) because of their fragile immune systems, the need for mechanical ventilation and prolonged hospital stays. VAP can lead to severe complications, including increased morbidity, mortality and long-term health issues. Training NICU nurses on VAP prevention care bundles is crucial for improving neonatal care, reducing preventable infections and optimizing clinical outcomes in a highly vulnerable neonatal population. It supports evidence-based practice, enhances nurse competence and contributes to the overall quality of care in neonatal intensive care settings. As a result, implementing such a training programme should be a top priority in NICU clinical practice.",
    "authors": [
        {
            "affiliation": "Pediatric Nursing Department, Faculty of Nursing, Damanhur University, Damanhur City, Egypt.",
            "firstname": "Basma Ibrahim Khamis",
            "initials": "BIK",
            "lastname": "Elsaeed"
        },
        {
            "affiliation": "Nursing Department, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Wadi Addawasir City, Saudi Arabia.\nPsychiatric and Mental Health Nursing Department, Faculty of Nursing, Alexandria University, Alexandria City, Egypt.",
            "firstname": "Mohamed Hussein Ramadan",
            "initials": "MHR",
            "lastname": "Atta"
        },
        {
            "affiliation": "Pediatric Nursing Department, Faculty of Nursing, Damanhur University, Damanhur City, Egypt.",
            "firstname": "Maha Ebrahim",
            "initials": "ME",
            "lastname": "Fouda"
        },
        {
            "affiliation": "Nursing Education Department, Faculty of Nursing, Damanhur University, Damanhur City, Egypt.",
            "firstname": "Hend Abo Elsoud",
            "initials": "HAE",
            "lastname": "Ahmed"
        },
        {
            "affiliation": "Nursing Education Department, Faculty of Nursing, Damanhur University, Damanhur City, Egypt.\nFaculty of Applied Health Sciences Technology, Galala University, Galala City, Egypt.",
            "firstname": "Doaa",
            "initials": "D",
            "lastname": "El Demerdash"
        },
        {
            "affiliation": "Pediatric Nursing Department, Faculty of Nursing, Damanhur University, Damanhur City, Egypt.",
            "firstname": "Gehan Abdelslam Mahmoud",
            "initials": "GAM",
            "lastname": "Elzlbany"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2025 British Association of Critical Care Nurses.",
    "doi": "10.1111/nicc.70000",
    "journal": "Nursing in critical care",
    "keywords": [
        "associated pneumonia",
        "care bundle",
        "newborns",
        "nurses",
        "training\u00a0"
    ],
    "methods": null,
    "publication_date": "2025-03-13",
    "pubmed_id": "40074557",
    "results": "The results indicate significantly improved nurses' practices for VAP prevention across the core, equipment-related general measures, with total mean scores increasing from 50.67% (95% CI: 44.30-56.92) pre-programme to 89.26% (95% CI: 85.68-92.84) immediately post-programme and 73.33% (95% CI: 67.79-78.88) after 3\u2009months (p\u2009<\u2009.001). Before the programme, 85.3% of newborns developed VAP. However, this dropped dramatically to just 10.5% immediately after the programme, with a relative risk of 0.123 (95% CI: 0.046-0.328, p\u2009<\u2009.001). Even 3 months later, the rates remained much lower at 19.5% than before the programme, with a relative risk of 0.228 (95% CI: 0.117-0.445, p\u2009<\u2009.001). Multivariate logistic regression showed that only overall nurses' practices remained statistically significant in reducing VAP risk (OR\u2009=\u20090.819, 95% CI: 0.728-0.920, p\u2009=\u2009.001) after adjusting for confounders. Prolonged ventilation and individual components of nursing practices were not significant in the multivariate model.",
    "title": "Effect of implementing training programme for nurses about care bundle on prevention of ventilator-associated pneumonia among newborns.",
    "xml": "<Element 'PubmedArticle' at 0x7885059a1da0>"
}