title: Ventilator-associated pneumonia: prevention is better than cure.
abstract: BACKGROUND
  The prevention of ventilator Assisted Pneumonia (VAP), a hospital acquired infection, among intensive care patients is a major clinical challenge. It is a condition that is associated with high rates of morbidity, mortality, length of stay and hospital costs.
  
  
  OBJECTIVE
  The aim of this paper is to critically review the available literature and identify current evidence based nursing and medical interventions to support practitioners in preventing VAP in their patients.
  
  
  METHODS
  A literature search using keywords, including 'ventilator-associated pneumonia' were entered into a search engine. A number of highly pertinent papers relevant to the aims of the review were identified, however only a small sample came from nursing journals. Only those papers, which discussed specific strategies for managing VAP were selected for analysis and inclusion in this review.
  
  
  CONCLUSIONS
  We identified a number of practical and evidence based strategies that nurses can incorporate into their practice to prevent VAP and to reduce its incidence. In addition, the introduction of newer techniques, advances in equipment and use of multidisciplinary care bundles can further support and improve the quality and delivery of safe patient care.
  
  
  CONCLUSIONS
  Targeted strategies aimed at preventing VAP, should be implemented to improve patient outcome and reduce length of intensive care unit stay and costs. Front-line critical care nurses need to understand the factors which place their patients at risk of developing VAP and, institute evidence-based interventions that will compromise the patients' survival and recovery.
authors.affiliation: Critical Care, Colchester General Hospital, Colchester, UK. alison.ruffell@essexrivers.nhs.uk
authors.forename: Alison
authors.initials: A
authors.lastname: Ruffell
authors.forename: Lenka
authors.initials: L
authors.lastname: Adamcova
mesh_terms: D002985:Clinical Protocols; D005060:Europe / Q000453:epidemiology; D019317:Evidence-Based Medicine; D006801:Humans; D017053:Infection Control / Q000379:methods*; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology / Q000517:prevention & control*