<![CDATA[ABSTRACT Ventilator-Associated Pneumonia (VAP) is a common nosocomial infection in ICUs, contributing significantly to morbidity, mortality, and healthcare costs. Implementing VAP bundles has shown effectiveness in reducing VAP incidence, but its success depends on various internal and external factors. This study employed a literature review with a quantitative approach. Data were gathered from 27 relevant articles published between 2013 and 2023, selected from an initial 231 articles obtained through structured searches in Google Scholar, PubMed, Scopus, and ScienceDirect using Boolean keywords such as “Ventilator-Associated Pneumonia” AND “VAP bundle” AND “Compliance.” Analysis revealed that internal factors, including medical staff knowledge and competency, significantly affect compliance with VAP bundles. Challenges such as insufficient continuous training and limited resources were highlighted. External factors, such as regular audits, managerial support, and a conducive work environment, were identified as critical in supporting successful VAP bundle implementation. Addressing internal challenges through structured training programs and resource allocation is essential. Simultaneously, external support mechanisms like frequent audits and strong managerial backing are necessary to ensure sustained compliance with VAP bundles. An integrative approach that encompasses intensive training, routine audits, and reinforced institutional policies is vital for the effective implementation of VAP bundles, thereby improving ICU patient care quality. Keywords: Ventilator-Associated Pneumonia, VAP Bundle, Internal Factors, External Factors, Protocol Compliance, ICU. ABSTRAK Ventilator-Associated Pneumonia (VAP) merupakan infeksi nosokomial yang umum terjadi di ruang ICU, yang berkontribusi secara signifikan terhadap morbiditas, mortalitas, dan biaya perawatan. Implementasi bundle VAP terbukti efektif dalam menurunkan angka kejadian VAP, namun keberhasilannya bergantung pada berbagai faktor internal dan eksternal. Penelitian ini menggunakan metode tinjauan literatur dengan pendekatan kuantitatif. Data dikumpulkan dari 27 artikel relevan yang diterbitkan antara tahun 2013 hingga 2023, diseleksi dari 231 artikel awal yang diperoleh melalui pencarian terstruktur di Google Scholar, PubMed, Scopus, dan ScienceDirect dengan kata kunci Boolean seperti “Ventilator-Associated Pneumonia” AND “VAP bundle” AND “Compliance.” Analisis menunjukkan bahwa faktor internal, termasuk pengetahuan dan kompetensi staf medis, secara signifikan memengaruhi kepatuhan terhadap bundle VAP. Hambatan seperti kurangnya pelatihan berkelanjutan dan keterbatasan sumber daya menjadi tantangan utama. Faktor eksternal seperti audit rutin, dukungan manajerial, dan lingkungan kerja yang kondusif diidentifikasi sebagai elemen penting dalam mendukung keberhasilan implementasi bundle VAP. Mengatasi tantangan internal melalui program pelatihan terstruktur dan penyediaan sumber daya sangat diperlukan. Di sisi lain, mekanisme dukungan eksternal seperti audit berkala dan dukungan manajerial yang kuat juga esensial untuk memastikan kepatuhan berkelanjutan terhadap bundle VAP. Pendekatan integratif yang mencakup pelatihan intensif, audit rutin, dan penguatan kebijakan institusional sangat penting untuk implementasi bundle VAP yang efektif, sehingga meningkatkan kualitas perawatan pasien di ruang ICU. Kata Kunci: Ventilator-Associated Pneumonia, Bundle VAP, Faktor Internal, Faktor Eksternal, Kepatuhan Protokol, ICU.]]>
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