Kontakt X:X | DOI: 10.32725/kont.2026.032

The cornerstones of the ventilator-associated pneumonia preventive bundle in critically ill adults - a Czech national surveyNursing - Original article

Kateřina Rambousková1, 2, *, Šárka Línková1, 2, Kateřina Jiroutková ORCID...1, 2, Veronika Šnorbertová (born Hložková)2, Veronika Dorazilová3, Zuzana Klikarová4, Johanka Hrdinová (born Pumprová)2, Barbora Havelková2
1 Charles University, 3rd Faculty of Medicine, Prague, Czech Republic
2 Královské Vinohrady University Hospital, Department of Anaesthesiology and Resuscitation, Prague, Czech Republic
3 Královské Vinohrady University Hospital, Surgical Clinic, Prague, Czech Republic
4 Institute of Clinical and Experimental Medicine, Department of Transplant Surgery, Prague, Czech Republic

Background: Ventilator-associated pneumonia (VAP) is the most common hospital-acquired infection in the intensive care unit (ICU). Given that prevention is key, efforts to develop effective measures have been encouraged. In 2004, the first "ventilator bundle" was introduced, consisting of four components. Daily oral care with chlorhexidine was added in 2010. This issue remains a subject of ongoing debate.

Aim: Identify current practices regarding the VAP bundle for invasively ventilated patients in ICUs in the Czech Republic, focusing on nursing intervention bundles, VAP incidence, VAP prevention education, and oral care protocols.

Results: A questionnaire was sent to a single representative of each ICU in the Czech Republic. The response rate was 32% (43 ICUs). We found substantial heterogeneity in the intensity and combinations of preventive measures; some of our findings are particularly concerning. 74% of ICUs did not keep VAP incidence records. 21% of ICUs did not provide education on the VAP preventive measures. 61% of ICUs used a suction pump connected to a central vacuum line or an electrical supply for subglottic secretion suction. 31% of ICUs used both active and passive humidification simultaneously.

Conclusion: A uniform VAP bundle is lacking in the Czech Republic, and potentially harmful interventions persist. There is an urgent need for national guidelines.

Keywords: Education; Intensive care; Nursing staff and preventive bundle; Ventilator-associated pneumonia
Grants and funding:

This work was funded by the Internal Grant of The Královské Vinohrady University Hospital, number IGS-2024-02.

Conflicts of interest:

The authors have no conflict of interest to declare.

Received: January 2, 2026; Revised: March 25, 2026; Accepted: May 21, 2026; Prepublished online: May 26, 2026 

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