Introduction:

The ventilator associated pneumonia (VAP) is one of the most common hospital-acquired risk associated with the patients on a Mechanical Ventilator (MV) which can be preventable by incorporating the VAP care bundle as a daily routine component of care in the ventilator patient’s in ICU, and can be considered as a nursing-sensitive indicator that reflects patient outcomes [1]. The problem of providing appropriate ventilation with minimal difficulties is crucial, as the lungs are typically one of the principal organs involved in multiple organ failure. With a crude mortality rate of about 30%, nosocomial pneumonia is one of the most common hospital-acquired infection-related causes of death. One type of infection that patients on mechanical ventilation can develop is called ventilator-associated pneumonia (VAP) [1]. In order to reduce the negative impact of VAP, the Institute of Healthcare Improvement (IHI) has suggested the use of "Ventilator Associated Pneumonia (VAP) Bundles of Care." This bundle includes several measures, such as preventing deep vein thrombosis (DVT), maintaining oral hygiene with Chlorhexidine, conducting spontaneous breathing tests, taking breaks from sedation, preventing peptic ulcers, and keeping the patient's head elevated at an angle of 30° to 45°. According to the Institute of Healthcare Improvement, this initiative has successfully stopped more than 122,000 fatalities and reduced the length of hospital stays and reliance on mechanical breathing. [1]. To completely eliminate cases of Ventilator Acquired Pneumonia (VAP), a compliance rate of over 95% with the VAP bundle is often necessary [2]. Regular assessments of the medical and nursing personnel are also recommended to improve long-term adherence. However, despite implementing this approach, VAP still remains the most common form of hospital-acquired pneumonia [3]. The health care worker working in critical care units are supposed to deliver high quality care by incorporating evidence-based practices related to VAP prevention [4]. Studies have mentioned that despite having many evidence-based guidelines on VAP prevention; lack of knowledge and compliance in nursing practices is a noticeable cause of VAP [5, 6]. This study aimed to assess the adherence of healthcare personnel regarding VAP prevention strategies and the VAP bundle.