{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T18:28:59Z","timestamp":1793644139095,"version":"4.5.1"},"reference-count":47,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing Open"],"published-print":{"date-parts":[[2026,7]]},"abstract":"ABSTRACT<\/jats:title>\n \n Aim<\/jats:title>\n To evaluate the effect of a structured training intervention on ICU nurses' knowledge\u2010based competence in VAP prevention in a resource\u2010limited setting and identify personal, environmental and organisational barriers to implementation.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n An explanatory sequential mixed\u2010methods design was employed, integrating a single\u2010group quasi\u2010experimental pre\u2010test\u2013post\u2010test quantitative strand with a qualitative interview strand. Because participant responses were not linked across assessment points, findings represent group\u2010level improvements rather than within\u2010individual change.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n ICU nurses completed pre\u2010test (\n n<\/jats:italic>\n \u2009=\u200957) and post\u2010test (\n n<\/jats:italic>\n \u2009=\u200956) assessments using an adapted eight\u2010item VAP prevention knowledge questionnaire. A structured 3\u2010h workshop on VAP prevention bundles, infection control and airway management was delivered between tests; the post\u2010test occurred within 2\u2009weeks. Group differences were analysed using an independent\u2010samples\n t<\/jats:italic>\n \u2010test and chi\u2010square tests. Qualitative interview data (\n n<\/jats:italic>\n \u2009=\u20098) were analysed thematically to explain and contextualise the quantitative findings.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Mean knowledge scores increased from 3.63 (SD 1.57) to 5.29 (SD 1.57) out of 8 (t(111)\u2009=\u2009\u22125.61,\n p<\/jats:italic>\n \u2009<\u20090.001;\n d<\/jats:italic>\n \u2009=\u20091.06). Because participant responses were not linked across assessment points, findings represent group\u2010level improvements rather than within\u2010individual change. The proportion classified as high knowledge\u2010based competence increased from 24.6% to 64.3% (\n \u03c7<\/jats:italic>\n 2<\/jats:sup>\n (2)\u2009=\u200922.43,\n p<\/jats:italic>\n \u2009<\u20090.001). Experience variables did not predict post\u2010test scores. Qualitative findings showed that shortages of supplies\/equipment, unreliable power, absent protocols, limited supervision and high workload restricted consistent implementation. These findings highlight that improvements in knowledge may not translate into consistent bedside practice without system\u2010level support in resource\u2010limited ICUs.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n A brief, context\u2010specific training workshop significantly improved ICU nurses' knowledge\u2010based competence in VAP prevention. However, systemic barriers\u2014equipment shortages, absent protocols, limited supervision and workload pressures\u2014constrain the translation of knowledge gains into consistent bedside practice. Sustainable improvement requires embedding education within broader quality improvement efforts.<\/jats:p>\n <\/jats:sec>\n \n No Patient or Public Contribution<\/jats:title>\n No patient or public contribution.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/nop2.70662","type":"journal-article","created":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T04:26:11Z","timestamp":1782275171000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Structured Training on\n ICU<\/scp>\n Nurses' Knowledge\u2010Based Competence in Ventilator\u2010Associated Pneumonia Prevention in a Resource\u2010Limited Setting: An Explanatory Sequential Mixed\u2010Methods Study"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5025-6299","authenticated-orcid":false,"given":"Yakubu H.","family":"Yakubu","sequence":"first","affiliation":[{"name":"Goldfields University Department of Rural Health, Faculty of Health Sciences Curtin University Kalgoorlie Australia"},{"name":"Faculty of Critical Care Nursing, Division of Nursing Ghana College of Nurses and Midwives Accra Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7935-1466","authenticated-orcid":false,"given":"Muniru Mohammed","family":"Saani","sequence":"additional","affiliation":[{"name":"Faculty of Critical Care Nursing, Division of Nursing Ghana College of Nurses and Midwives Accra Ghana"},{"name":"Department of Intensive Care Unit Tamale Teaching Hospital Tamale Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,23]]},"reference":[{"key":"e_1_2_18_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135\u2010024\u201002022\u20105"},{"key":"e_1_2_18_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare13212782"},{"key":"e_1_2_18_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijn.12838"},{"key":"e_1_2_18_5_1","doi-asserted-by":"publisher","DOI":"10.12688\/f1000research.128144.2"},{"key":"e_1_2_18_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01663995"},{"key":"e_1_2_18_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-021-00735-8"},{"issue":"3","key":"e_1_2_18_8_1","first-page":"402","article-title":"From Novice to Expert","volume":"82","author":"Benner P.","year":"1982","journal-title":"AJN, American Journal of Nursing"},{"key":"e_1_2_18_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2022.103227"},{"key":"e_1_2_18_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134\u2010007\u20100705\u20100"},{"key":"e_1_2_18_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-69909-7_3470-2"},{"key":"e_1_2_18_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879\u2010014\u20100593\u20101"},{"key":"e_1_2_18_13_1","volume-title":"Designing and Conducting Mixed Methods Research","author":"Creswell J. 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