Nursing Interventions for the Prevention of Ventilator-Associated Pneumonia in Adult Intensive Care Units in Africa

Abstract

Ventilator-Associated Pneumonia (VAP) remains a significant challenge to global health, even as it is ranked as not only one of the most common but also one of the most severe hospital-acquired infections, especially in adult intensive care units (ICUs). Statistically, among all cases involving mechanically ventilated patients, VAP is estimated to be responsible for 9-27% of cases globally. This is significant as it contributes to various issues, such as high mortality rates and prolonged hospital admissions, which also lead to a high cost of healthcare. The situation in ICUs in Africa is predominantly very grave, with VAP occurrence projected to be at a rate of somewhere between 20 and 45 cases for every 1,000 ventilator days, which is considerably higher than the global average. Research done in healthcare in Africa shown that there is a gap in adherence mainly because of a lack of education, insufficient equipment, and systemic challenges, including high workload and insufficient supervision. Thus, there is an urgency to investigate the things as they stand, their effectiveness, and barriers for interventions and prevention of VAP within ICUs in Africa. This study employed a scoping review design that followed the methodological design developed by Arksey & O’Malley (2005), and it was also refined by the Joanna Briggs Institute (JBI, 2020). Descriptive synthesis was employed in the analysis of the data extracted. Thematic grouping of results was done based on topics such as prevention, impact of policy, attitudes, and knowledge of nurses and barrier association. The reviewed studies collectively highlight that nursing interventions are central to reducing the incidence of VAP in adult intensive care units (ICUs) across Africa. Nevertheless, continuous enhancement in ICUs in Africa necessitates investment in training, policy alignment, and infrastructure support. The findings greatly postulate that reinforcing the capacity of nurses, being accountable in the organisation and systems, and scalability of global guidelines in various contexts is the most practical way that can help in reducing VAP-related morbidity and mortality in Africa. The study recommended instituting mandatory training periodically for ICU infection control for every practising nurse in the critical care and the adoption of the standardised WHO bundles and alignment of all VAP prevention in tertiary African hospitals