Ventilator-associated pneumonia among intensive care nurses: a multicenter cross-sectional study on knowledge and preventive measures in intensive care units of Mogadishu, Somalia

Background Ventilator-associated pneumonia (VAP) remains a major healthcare-associated infection in intensive care units (ICUs), and its prevention largely depends on nurses’ knowledge, attitudes, and adherence to recommended practices. Assessing these factors is essential for improving patient safety and the quality of ICU care. This study assessed the knowledge, attitudes, and preventive practices regarding VAP among ICU nurses in Mogadishu, Somalia. Methods A multicenter descriptive cross-sectional study was conducted among 122 ICU nurses from five purposively selected hospitals in Mogadishu. Data were collected using a structured, validated self-administered questionnaire assessing socio-demographic characteristics, VAP-related knowledge, attitudes, and preventive practices. Descriptive statistics and Chi-square tests were performed using SPSS version 23, with statistical significance set at p  < 0.05. Results Most participants were aged 20–30 years (54.1%), male (52.5%), held a bachelor's degree (69.7%), and had received VAP training (73.8%). Overall, 85.2% of nurses demonstrated moderate knowledge, while 14.8% had good knowledge. Preventive measures such as hand hygiene (95.1%), sterile glove use (87.7%), and head-of-bed elevation (78.7%) were widely recognized. However, attitudes were predominantly poor, with 73.8% scoring below 50%, despite high recognition of oral care importance (83.6%). Preventive practices were also suboptimal, with 67.2% demonstrating poor practice levels. Although hand hygiene (73.8%) and glove use (69.7%) were commonly performed, only 50.8% consistently maintained the recommended semi-recumbent position. Significant associations were observed between socio-demographic characteristics and knowledge, attitudes, and practices ( p  < 0.001). Conclusion ICU nurses demonstrated moderate knowledge but poor attitudes and preventive practices regarding VAP prevention. Structured training, standardized protocols, and institutional support are needed to improve compliance and enhance patient safety.