Abstract: Objective: To investigate the differences in knowledge and practice regarding Ventilator-Associated Pneumonia (VAP) prevention among emergency nurses at different hospital levels across the country, providing a reference for developing precise nursing intervention strategies for the early prevention and control of VAP in emergency settings. Methods: We employed a convenience sampling method to survey emergency nurses from secondary and tertiary hospitals from December 2024 to February 2025, using a self-designed questionnaire. Then statistical analysis of the data was conducted to compare the status of core VAP prevention knowledge and practice among nurses at different hospital levels. Results: A total of 980 valid questionnaires were collected from 83 hospitals across 27 provinces (autonomous regions, municipalities), including 27 secondary and 56 tertiary hospitals. The overall correct response rate for core VAP prevention knowledge was 56.46%. Significant differences were observed between nurses from secondary and tertiary hospitals in their knowledge of position management, cuff pressure monitoring, endotracheal suctioning care, and sedation assessment (all P<0.05). Regarding practice, statistically significant differences were identified between nurses in secondary and tertiary hospitals as to the method and frequency of subglottic secretion drainage, cuff pressure monitoring frequency, endotracheal suctioning method, selection of oral care solution, oral irrigation, gastric decompression within 1 hour after intubation, and suctioning sequence (all P<0.05). Conclusion: Both the knowledge and practice regarding VAP prevention among emergency nurses in China require improvement. Therefore, it is recommended that hospitals implement tiered intervention strategies tailored to themselves to systematically enhance the VAP prevention and control capabilities of emergency nurses.

Key words: Ventilator-Associated Pneumonia; emergency department; nursing; practice