{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:50:00Z","timestamp":1792698600993,"version":"4.5.0"},"reference-count":37,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T00:00:00Z","timestamp":1741737600000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,1]],"date-time":"2025-03-01T00:00:00Z","timestamp":1740787200000},"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 in Critical Care"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Ventilator\u2010associated 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\u2010based practices reduces VAP incidence. As primary caregivers, nurses are critical in consistently applying these preventive measures in NICU settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the impact of a structured training programme on nurses' practices in the prevention of VAP among ventilated newborns in NICUs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>This prospective, pre\u2010 and post\u2010intervention 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\u2010intervention, 38 newborns post\u2010intervention and 41 newborns 3\u2009months after the intervention).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The results indicate significantly improved nurses' practices for VAP prevention across the core, equipment\u2010related general measures, with total mean scores increasing from 50.67% (95% CI: 44.30\u201356.92) pre\u2010programme to 89.26% (95% CI: 85.68\u201392.84) immediately post\u2010programme and 73.33% (95% CI: 67.79\u201378.88) after 3\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\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\u20130.328,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\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\u20130.445,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\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\u20130.920,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001) after adjusting for confounders. Prolonged ventilation and individual components of nursing practices were not significant in the multivariate model.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>Newborns in the neonatal intensive care unit (NICU) are at a higher risk of developing ventilator\u2010associated 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\u2010term 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\u2010based 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70000","type":"journal-article","created":{"date-parts":[[2025,3,12]],"date-time":"2025-03-12T22:38:22Z","timestamp":1741819102000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Effect of implementing training programme for nurses about care bundle on prevention of ventilator\u2010associated pneumonia among newborns"],"prefix":"10.1111","volume":"30","author":[{"given":"Basma Ibrahim Khamis","family":"Elsaeed","sequence":"first","affiliation":[{"name":"Pediatric Nursing Department, Faculty of Nursing Damanhur University  Damanhur City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5518-0892","authenticated-orcid":false,"given":"Mohamed Hussein Ramadan","family":"Atta","sequence":"additional","affiliation":[{"name":"Nursing Department, College of Applied Medical Sciences Prince Sattam Bin Abdulaziz University  Wadi Addawasir City Saudi Arabia"},{"name":"Psychiatric and Mental Health Nursing Department, Faculty of Nursing Alexandria University  Alexandria City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha Ebrahim","family":"Fouda","sequence":"additional","affiliation":[{"name":"Pediatric Nursing Department, Faculty of Nursing Damanhur University  Damanhur City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hend Abo Elsoud","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Nursing Education Department, Faculty of Nursing Damanhur University  Damanhur City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doaa","family":"El Demerdash","sequence":"additional","affiliation":[{"name":"Nursing Education Department, Faculty of Nursing Damanhur University  Damanhur City Egypt"},{"name":"Faculty of Applied Health Sciences Technology Galala University  Galala City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gehan Abdelslam Mahmoud","family":"Elzlbany","sequence":"additional","affiliation":[{"name":"Pediatric Nursing Department, Faculty of Nursing Damanhur University  Damanhur City Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,3,12]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics14030240"},{"key":"e_1_2_13_3_1","volume-title":"Pneumonia (Ventilator\u2010associated [VAP] and Non\u2010ventilator\u2010associated Pneumonia [PNEU]) Event","author":"National Healthcare Safety Network (NHSN)","year":"2024"},{"key":"e_1_2_13_4_1","volume-title":"Pneumonia (Ventilator\u2010associated [VAP] and Nonventilator\u2010associated Pneumonia [PNEU]) Event","author":"Centers for Disease Control and 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