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With respect to the article by Labeau et al,¹ we believe that development of a questionnaire to accurately evaluate nurses’ knowledge of current ventilator-associated pneumonia (VAP) guidelines is an admirable pursuit. Appreciating the knowledge gap in this area is crucial as healthcare and medicine continue to advance. The incidence of VAP and related morbidity and mortality can be reduced by preventive measures such as those mentioned in the article (eg, semirecumbent positioning, circuit changes).

In our coronary care unit at a tertiary hospital in upstate New York, we implemented a similar plan, monitoring nursing compliance with strategies for reducing the prevalence of VAP. Only through chart reviews and interviewing staff members did we discover that unassisted ventilator trials (UVTs) were not routinely being performed for patients who needed them; in fact, only 70% of ventilated patients who qualified were receiving this recognized preventive measure. When we realized that 30% of our patients were not receiving UVTs, we reviewed and updated our ventilator protocol to meet the needs of this patient population.

As compliance with the overall protocol has increased, we have continued to maintain a 0% incidence of VAP. Cardiac exclusion criteria also have been added to our protocols, resulting in no UVTs being necessary for our intra-aortic balloon pump patients. This key evidence-based bundle ought to include a multidisciplinary approach beginning with nurses; subsequent education for respiratory and medical staff might help to increase compliance.

We appreciate the article by Labeau and colleagues, which helped us to expand our own understanding of VAP and VAP prevention.

Amelia Dawes, RN, BS and Mary Perrecone, RN, MS, CCRN, CNN
Albany Medical Center, Albany, New York

REFERENCE

1. Labeau S, Vandijck DM, Claes B, Van Aken P, Blot SI. Critical care nurses’ knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia: an evaluation questionnaire. Am J Crit Care. 2007;16(4):371–377.[Abstract/Free Full Text]

This Article Full Text (PDF) Respond to This Article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Dawes, A. Articles by Perrecone, M. Search for Related Content PubMed PubMed Citation Articles by Dawes, A. Articles by Perrecone, M.