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March 17, 2026The Brazilian Journal of Infectious Diseases0 citationsOpen Access

Audit of Adherence to Prevention Measures for Non–ventilator-Associated Pneumonia in a Tertiary Hospital

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MPMauricio Sério de PaulaSSSamuel Rodrigues dos SantosRBRenata Aparecida Belei

Key Points

  • Examine adherence to prevention measures for non-ventilator-associated pneumonia (NVAP) in various hospital sectors.
  • Descriptive, cross-sectional, quantitative observational design
  • Conducted in a public tertiary hospital
  • Data collection from 2,211 observations using a Google Forms® audit tool
  • Involves inpatient units, emergency departments, and recovery rooms
  • Observations made during morning, afternoon, and night shifts
  • 81.6% adherence to head-of-bed elevation measures
  • 56.2% did not perform oral hygiene three times daily
  • 31.3% did not provide respiratory physiotherapy
  • 38.5% adherence to early ambulation
  • 69.8% lack of postoperative analgesia despite high surgery volume

Abstract

Non–ventilator-associated pneumonia (NVAP) is highly relevant because it affects patients whose airway immune barriers are not compromised by devices. Despite this, incidence remains high. To analyze adherence to NVAP prevention measures across hospital sectors. Descriptive, cross-sectional, quantitative observational study in a public tertiary university hospital in Northern Paraná, including inpatient units, emergency departments, and post-anesthesia recovery room. Data were collected by infection control committee interns from March 2024 to June 2025 (morning/afternoon/night) using an institutional Google Forms® audit tool. A total of 2,211 observations were collected: 52.7% in the morning, 37.8% afternoon, 9.5% night. Head-of-bed elevation 30–45° was present in 81.6%. Oral hygiene three times daily was not performed in 56.2%. Respiratory physiotherapy was not performed in 31.3%, though 40.9% were “not applicable.” Early ambulation occurred in only 38.5%. Postoperative analgesia was not provided in 69.8%, despite 800–1,000 surgeries per month. In 47.4%, nebulizer mask or bag-valve-mask was protected. NVAP prevention measures were not satisfactorily performed, increasing infection risk. Head-of-bed elevation showed highest adherence as it requires less work. Measures requiring more team effort—oral hygiene, early ambulation, and postoperative analgesia—had lower adherence. Prevention measures must be reinforced in wards to improve patient safety and care quality.

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Cite This Study

Paula et al. (2026) studied this question.

synapsesocial.com/papers/69b8ef6ddeb47d591b8c5786https://doi.org/10.1016/j.bjid.2026.105340
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