ArticleNursing open2026
Effect of Structured Training on ICU Nurses' Knowledge-Based Competence in Ventilator-Associated Pneumonia Prevention in a Resource-Limited Setting: An Explanatory Sequential Mixed-Methods Study.
Article in Nursing open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo evaluate the effect of a structured training intervention on ICU nurses' knowledge-based competence in VAP prevention in a resource-limited setting and identify personal, environmental and organisational barriers to implementation.
designAn explanatory sequential mixed-methods design was employed, integrating a single-group quasi-experimental pre-test-post-test quantitative strand with a qualitative interview strand. Because participant responses were not linked across assessment points, findings represent group-level improvements rather than within-individual change.
methodsICU nurses completed pre-test (n = 57) and post-test (n = 56) assessments using an adapted eight-item VAP prevention knowledge questionnaire. A structured 3-h workshop on VAP prevention bundles, infection control and airway management was delivered between tests; the post-test occurred within 2 weeks. Group differences were analysed using an independent-samples t-test and chi-square tests. Qualitative interview data (n = 8) were analysed thematically to explain and contextualise the quantitative findings.
resultsMean knowledge scores increased from 3.63 (SD 1.57) to 5.29 (SD 1.57) out of 8 (t(111) = -5.61, p < 0.001; d = 1.06). Because participant responses were not linked across assessment points, findings represent group-level improvements rather than within-individual change. The proportion classified as high knowledge-based competence increased from 24.6% to 64.3% (χ
conclusionsA brief, context-specific training workshop significantly improved ICU nurses' knowledge-based competence in VAP prevention. However, systemic barriers-equipment shortages, absent protocols, limited supervision and workload pressures-constrain the translation of knowledge gains into consistent bedside practice. Sustainable improvement requires embedding education within broader quality improvement efforts. NO PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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