Development of a Prevention Model for Ventilator-Associated Pneumonia in Intensive Care Unit Patients at Thabo Crown Prince Hospital, Nong Khai Province

Abstract

Background and Objectives Patients who undergo endotracheal intubation and mechanical ventilation are approximately 3–20 times more likely to develop pneumonia than general patients. Continuous surveillance and infection prevention are therefore essential, particularly for professional nurses who play a critical role in patient care. This study aimed to investigate the current situation, develop a model, and evaluate the effectiveness of a pneumonia prevention model for mechanically ventilated patients in the intensive care unit at Thabo Crown Prince Hospital, Nong Khai Province.

Methods The research and development were conducted between January 2024 and June 2025 and consisted of three phases: 1) Studying the current situation and needs through a document review and qualitative research involving 10 registered nurses and 4 internists; 2) Developing the model; and 3) Examining the effectiveness of the model. The research instruments were validated by three experts, yielding an Index of Item-Objective Congruence (IOC) ranging from 0.67 to 1.00. The instruments used included the TIH2E Model, an infection data record form, a satisfaction evaluation form, and an observation form for model implementation. A one-group pretest-posttest quasi-experimental design was employed. The study sample consisted of 23 registered nurses and 34 patients on mechanical ventilation. Data were analyzed using descriptive statistics and the one-sample t-test.

Results A retrospective review (2021–2023) revealed an increasing trend of ventilator-associated pneumonia: VAP incidence. Nursing practice in VAP bundle implementation was incomplete and lacked continuous monitoring. The TIH2E Model comprised: 1) Team (multidisciplinary team), 2) Implementation, 3) Health education (for caregivers), 4) Environment (environmental management), and 5) Evaluation (monitoring and evaluation). After implementation, 76.50 % of patients did not develop VAP. Nurses reported satisfaction levels exceeding 80 %, and adherence to the model was greater than 95 %, with statistically significant improvement (p < .001).

Conclusions and Recommendations The TIH2E Model proved effective in enhancing nursing practices and reducing ventilator-associated pneumonia among mechanically ventilated patients. The model contributes to improved quality of care and patient safety.