Consent Form
You are invited to participate in an evidence-based project conducted by 4th-year
BSN nursing students. This project aims to assess the knowledge, attitudes, and
practices of critical care nurses regarding compliance with the ventilator care
bundle (VCB) for preventing ventilator-associated pneumonia (VAP). Your
participation will contribute to improving nursing practices related to VCB
compliance, ultimately enhancing patient outcomes. Your participation is entirely
voluntary, the information collected will be reported in aggregate form, ensuring
your anonymity and confidentiality. By signing below, you acknowledge that you
have read and understood the information provided, and you voluntarily agree to
participate in the study.
Participant Name: _____________________
Signature: ___________________________
Date: _______________________________
Researcher Name: ____________________
Signature: ___________________________
Date: _______________________________
Questionnaire for Assessing ICU Nurses’ Knowledge, Attitude and Practices
of VCB for Preventing Ventilator-Associated Pneumonia.
Part A: Demographic Information
1. Age:
2. Gender:
3. Professional Qualification:
4. Clinical Experience:
5. Unit Area:
Part B: ICU Nurses’ Knowledge of Ventilator Care Bundle (VCB)
1. VCB is:
☐ A checklist used as a protocol of care for mechanically ventilated patients.
☐ Guidelines used to reduce the risk of atelectasis.
☐ Interventions to treat malignancies of lungs.
☐ I do not know.
2. Non-compliance to VCB is associated with:
☐ Decreased risk of VAP.
☐ High mortality in mechanically ventilated patients.
☐ Reduced morbidity in mechanically ventilated patients.
☐ I don’t know.
3. Which component is not included in the VCB for the prevention of VAP?
☐ Oral care.
☐ Head of bed elevation.
☐ Daily sedation vacation.
☐ Administration of antibiotics.
4. VAP is likely to occur in patients who have received mechanical ventilation for:
☐ 6 hours.
☐ 12 hours.
☐ 24 hours.
☐ 48 hours.
5. Head of the bed elevation should be:
☐ 0-15 degrees.
☐ 15-30 degrees.
☐ 30-45 degrees.
☐ I do not know.
6. What is the effect of kinetic beds in the prevention of VAP?
☐ Increases the risk for VAP.
☐ Reduces the risk for VAP.
☐ No effect.
☐ I don’t know.
7. Evidence-based guidelines recommend changing ventilator circuits how frequently?
☐ Every 48 hours.
☐ Every 72 hours.
☐ Every week.
☐ Every new patient.
8. A nurse caring for a ventilated patient should wash hands:
☐ Before oral and ETT suctioning.
☐ After oral and ETT suctioning.
☐ Before and after oral / ETT suctioning.
☐ I don’t know.
9. Oral care with a swab moistened with Chlorhexidine 1% should be performed:
☐ Once per shift.
☐ Every 4 to 6 hours and whenever necessary.
☐ Twice daily.
☐ I do not know.
10. One of the components of VCB is:
☐ Chest physiotherapy.
☐ Sedation interruption.
☐ Daily ventilator circuit changes.
☐ I don’t know.
11. Early weaning:
☐ Reduces the risk for VAP.
☐ Increases the risk for VAP.
☐ Does not influence the risk for VAP.
☐ I don’t know.
12. Contraindications for DVT prophylaxis include:
☐ Thrombocytopenia (HIT).
☐ Active bleeding (GI bleed).
☐ Presumed or confirmed clot in lower extremity.
☐ All of the above.
Part C: Checklist for VCB Practices
no Statement Yes No
1 Do you routinely elevate the head of the bed to 30-45° for
mechanically ventilated patients?
2 When elevating the head of the bed, do you consider any
contraindications (e.g., spinal injuries, respiratory distress)?
3 Do you position patients in a semi-recumbent position when
providing oral care?
4 Do you wear clean gloves while providing oral care?
5 Do you use 1% Chlorhexidine for oral care as per hospital policy?
6 Do you implement daily sedation vacations for mechanically
ventilated patients according to hospital policy?
7 Do you conduct spontaneous breathing trials as ordered by the
physician?
8 Do you provide peptic ulcer prophylaxis as prescribed by the
doctor?
9 Is your provision of peptic ulcer prophylaxis consistent with
hospital policy?
10 Do you provide DVT prophylaxis as prescribed by the doctor?
11 When providing DVT prophylaxis, do you consider any
contraindications for mechanically ventilated patients?
Part D: ICU Nurses’ Attitudes Toward Ventilator Care Bundle (VCB)
no Statement Strongly Agree Neutral Disagree Strongly
Agree Disagree
1 I believe the VCB is effective in
reducing the incidence of VAP.
2 I find it challenging to follow all
the VCB components due to time
constraints.
3 I find it easy to maintain head-of-
bed elevation to 30-45° for
ventilated patients.
4 I believe daily sedation vacations
are important in reducing the risk
of VAP.
5 I feel adequately trained to
implement all elements of the VAP
bundle effectively.
6 I believe that using GI prophylaxis
as a standard VAP prevention
measure is effective in
mechanically ventilated patients.
7 I feel confident in administering
DVT prophylaxis as part of the
VAP bundle care.
8 I believe that providing oral
hygiene every 4 to 6 hours is
crucial in preventing VAP.
9 I believe that all components of the
VAP bundle are essential to reduce
the incidence of VAP in ICU
patients.
10 I believe continuous education and
training on VCB are necessary for
all ICU staff.
Box 1: Scoring system for the knowledge level
Score obtained Knowledge level categories
81-100% Excellent
61-80% Good
41-60% Average
< 40% Poor
Box 2: Scoring system for the Level of Adherence
Score obtained Level of Adherence
81-100% High Adherence
61-80% Moderate Adherence
41-60% Low Adherence
< 40% Poor Adherence
Box 3: Scoring system for the Attitude
Score obtained Attitude Level Categories
4-5 Positive Attitude
3 Neutral Attitude
1-2 Negative Attitude
