Intensive Care Nurses' Self‐Reported Adherence to Evidence‐Informed Microaspiration‐Prevention Practices and Potential Implementation Determinants: A Multicenter Cross‐Sectional Study

Aim

To assess intensive care nurses' self‐reported adherence to recommended microaspiration‐prevention practices and explore potential implementation determinants.

Design

Multicentre, cross‐sectional.

Methods

From December 2024 to February 2025, nurses in 31 intensive care units at 17 hospitals in Henan Province, China, completed a questionnaire on 22 preventive practices and 43 implementation‐related items informed by the Theoretical Domains Framework. Bivariate analyses, a fully adjusted three‐level mixed‐effects model accounting for unit and hospital clustering, and generalised estimating equation sensitivity analyses examined associations.

Results

Of 510 respondents, 476 were analysed. Mean adherence was 77.17/110 (70.15% of maximum), with basic care scoring highest (73.6%) and risk management lowest (67.2%). After adjustment, adherence was lower in units with 10–14, 15–19 and ≥ 20 beds than in those with < 5 beds; the 5–9‐bed group did not differ. Both training exposures were associated with higher adherence in the primary analysis; only evidence‐based practice training remained significant in the 14‐item analysis. The lowest‐scoring items concerned near‐term implementation intention (3.10), competing priorities (3.21), and professional responsibility (3.29); the highest concerned time efficiency (4.19), workflow compatibility (4.15) and interest (3.94).

Conclusion

Self‐reported adherence varied across practices and domains. Intensive care unit bed capacity and training exposure were associated with adherence, and implementation‐related findings identified potential areas for further investigation.

Implications for Nursing Practice

Findings may guide intensive care unit nurses, nurse managers, and educators in strengthening targeted microaspiration‐prevention training, clarifying responsibilities, integrating preventive practices into routine workflows, and reinforcing bedside supervision, particularly in units with 10–14, 15–19, or ≥ 20 beds.

Reporting Method

The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were followed.

Patient or Public Contribution: None