Continuous care for critically ill patients with ventilator-associated pneumonia: an integrative review

Abstract

Introduction: Ventilator-associated pneumonia is one of the leading infections in intensive care units and is associated with high morbidity, mortality, and healthcare costs. Prevention depends largely on the continuous care provided by nursing staff.

Objective: To identify the most effective continuous nursing care practices for preventing Ventilator-associated pneumonia in critically ill patients.

Methods: An integrative review was conducted using the Whittemore and Knafl methodology combined with the PRISMA guidelines. Open access studies published between 2021 and 2025 in Spanish, English, or Portuguese that evaluated nursing interventions or continuous care protocols for preventing Ventilator-associated pneumonia were searched in PubMed, ScienceDirect, and Google Scholar. Methodological quality was assessed using levels of evidence, and Level I and II studies were selected. Data on design, intervention, outcomes, and conclusions were extracted, and a thematic synthesis was performed.

Conclusions: Eight studies with a high level of evidence were included. The most effective interventions were the implementation of care bundles, head-of-bed elevation, oral hygiene, closed-system suctioning, cuff monitoring, oral care with chlorhexidine, semi-sitting positioning (30°–45°), and standardized secretion management. These measures reduced the incidence of ventilator-associated pneumonia, the number of days on mechanical ventilation, and the length of stay in intensive care units. Nursing interventions integrated into continuous care protocols constitute effective strategies for the prevention of Ventilator-associated pneumonia.