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<article xsi:noNamespaceSchemaLocation="http://jats.nlm.nih.gov/publishing/1.1/xsd/JATS-journalpublishing1-mathml3.xsd" dtd-version="1.1" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"><front><journal-meta><journal-id journal-id-type="publisher-id">JCNR</journal-id><journal-title-group><journal-title>Journal of Clinical and Nursing Research</journal-title></journal-title-group><issn>2208-3685</issn><eissn>2208-3693</eissn><publisher><publisher-name>Bio-Byword Scientific Publishing Pty. Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.26689/jcnr.v10i6.15575</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title>Effects of a TTM-based Stratified Intervention on VAP Prevention Behaviors among Multi-professional ICU Staff</title><url>https://artdesignp.com/journal/JCNR/10/6/10.26689/jcnr.v10i6.15575</url><author>HeJianyun,FuMinglong,YuanZhenzhen,HaoXiaoting,GaoShuping</author><pub-date pub-type="publication-year"><year>2026</year></pub-date><volume>10</volume><issue>6</issue><history><date date-type="pub"><published-time>2026-06-30</published-time></date></history><abstract>Objective: To evaluate VAP prevention behavioral characteristics and barriers among ICU physicians, nurses, and cleaners based on the Transtheoretical Model (TTM), and to verify the application effects of a stratified intervention model. Methods: A quasi-experimental study was conducted. In June 2025, a convenience sample of 205 ICU staff from 7 ICUs of a tertiary hospital was recruited. A self-designed questionnaire was used to construct the model, which was implemented for 6 months to compare behavioral stages and VAP incidence. Results: Before the intervention, significant differences were observed in behavioral stages among the groups (p &amp;lt; 0.05). The maintenance stage proportions for physicians, nurses, and cleaners were 71.87%, 41.14%, and 13.33%. After intervention, they increased to 84.38%, 58.23%, and 33.33%, respectively (p &amp;lt; 0.05). Subglottic secretion drainage compliance among nurses increased from 41.77% to 89.24%, and environmental cleaning compliance among cleaners increased from 26.67% to 86.67% (p &amp;lt; 0.05). VAP incidence decreased from 3.14 to 1.21 per 1,000 ventilator-days (p &amp;lt; 0.05). Conclusions: The model precisely matches occupational needs, promotes positive behavioral shifts, improves compliance, and significantly reduces VAP incidence.</abstract><keywords/></article-meta></front><body/><back><ref-list><ref id="B1" content-type="article"><label>1</label><element-citation publication-type="journal"><p>Zhang X, Lu Y, Chen J, et al., 2026, Risk Factors for Pathogens of Ventilator-Associated Pneumonia and Adverse Clinical Outcomes in ICU Patients Undergoing Mechanical Ventilation. Chinese Journal of Hospital Infection, 2026(3): 417–421.</p><pub-id pub-id-type="doi"/></element-citation></ref><ref id="B2" content-type="article"><label>2</label><element-citation publication-type="journal"><p>Papazian L, Klompas M, Luyt C, 2020, Ventilator-Associated Pneumonia in Adults: A Narrative Review. 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