Nursing bundle to prevent ventilator-associated pneumonia in intubated ICU patients: A review

Chhabra PH, Choudhuri AH, Kumar P

Pdf Page Numbers :- 64-68

Priyanka H Chhabra^1,*, Anirban H Choudhuri¹ and Pravin Kumar¹

¹Department of Critical Care Medicine, Vardhaman Mahavir Medical College & Safdarjung Hospital, Safdarjung Campus, Ansari Nagar West, New Delhi, Delhi 110029, India

*Corresponding author: Dr. Priyanka H Chhabra, Professor, Department of Critical Care Medicine, Vardhaman Mahavir Medical College & Safdarjung Hospital, Safdarjung Campus, Ansari Nagar West, New Delhi, Delhi 110029, India. Email: priyankahsinghani@gmail.com

Received 3 February 2026; Revised 9 March 2026; Accepted 20 March 2026; Published 30 March 2026

Citation: Chhabra PH, Choudhuri AH, Kumar P. Nursing bundle to prevent ventilator-associated pneumonia in intubated ICU patients: A review. J Med Sci Res. 2026; 14(2):64-68. DOI: http://dx.doi.org/10.17727/JMSR.2026/14-12

Copyright: © 2026 Chhabra PH et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Ventilator-associated pneumonia (VAP) remains one of the most important preventable infections in mechanically ventilated patients and continues to increase duration of ventilation, ICU (Intensive Care Unit) stay, antimicrobial exposure, and costs. Contemporary guidance has shifted from isolated interventions toward nursing-led, multidisciplinary bundles that improve reliability of evidence-based bedside care. This narrative review summarizes the rationale, structure, and implementation of a nursing bundle for preventing VAP in intubated adult ICU patients, with emphasis on measures that are practical in routine critical care and adaptable to resource-variable settings. Core components include head-of-bed elevation, daily oral care with toothbrushing, minimization of sedation, daily assessment for extubation readiness, prevention of reintubation, early mobility, ventilator-circuit stewardship, aspiration precautions, cuff management, and structured compliance monitoring. The evidence suggests that bundles work best when paired with staff education, surveillance, feedback, and local audit systems rather than as stand-alone checklists. A nursing bundle should therefore be seen not as a static protocol but as a behaviorally reinforced quality-improvement system embedded in ICU practice.

Keywords: pneumonia; ventilator-associated; intensive care units; infection control; patient care bundles; quality indicators