Ventilator-Associated Pneumonia (VAP) is a type of nosocomial infection that mostly occurs in intensive care units, generally occurring 48 hours after intubation. Endotracheal intubation and the use of a mechanical ventilator are invasive measures by patients, having a therapeutic effect. This paper aimed to identify the use of oral hygiene materials for the incidence of pneumonia related to the use of a ventilator. The research design was by searching literature in five databases, namely PubMed, Proquest, Science Direct, Wiley Online Library, and Google Scholar, by taking all databases in English and Indonesian, published in the last ten years (2010-2020). There were six articles about the effectiveness of using oral hygiene as risk prevention for Ventilator-Associated Pneumonia (VAP) with various concentrations and volumes. Several oral health assessment tools that can be used are Oral Assessment Guide, Beck Oral Assessment Scale, or Mucosal-Plaque Score. Comprehensive implementation of oral hygiene can improve the oral health of patients with mechanical ventilation, so bacterial colonization that causes VAP can be prevented. Therefore, nurses need to understand and apply oral assessment instruments as a basis for giving intervention.

This study aims to identify factors that influence nurse compliance and find the best solution to improve adherence to oral hygiene. The research method begins with searching scientific articles in 4 databases, namely PubMed, Wiley, science direct, and google scholar. The results of the study of 7 included articles, 42.85% (3 pieces) stated that nurses' knowledge and perceptions were the main factors that influenced nurse compliance, and 14.3% (1 article) indicated that service practices/facilities affected adherence. Other factors were found including; limited time, motivation, nurse workload, unavailability of oral hygiene procedures, and lack of interprofessional collaboration, so the best solution is to increase the knowledge and competence of nurses with training, workshops, and monitoring systems in the implementation of the VAP bundle. In conclusion, nurses' knowledge and perceptions are the main factors that affect nurse compliance in performing oral hygiene, so increasing knowledge and competence is the best solution as a joint effort to reduce the incidence of VAP.   Keywords: VAP Bundle, Compliance, Intensive Care Unit, Oral Hygiene