title: Ventilator-associated pneumonia bundle: reconstruction for best care.
abstract: The ventilator-associated pneumonia (VAP) bundle is a focus of many health care institutions. Many hospitals are conducting process-improvement projects in an attempt to improve VAP rates by implementing the bundle. However, this bundle is controversial in the literature, because the evidence supporting the VAP interventions is weak. In addition, definitions used for surveillance are interpreted differently than definitions used for clinical diagnosis. The variance in definitions has led to lower reported VAP rates, which may not be accurate. Because of the variance in definitions, the Centers for Disease Control and Prevention developed a ventilator-associated event algorithm. Health care institutions are under pressure to reduce the VAP infection rate, but correctly identifying VAP can be very challenging. This article reviews the current evidence related to VAP and provides insight into implementing a suggested revision of the care of patients being treated with mechanical ventilation.
authors.affiliation: Nancy Munro is Senior Acute Care Nurse Practitioner, National Institutes of Health, Critical Care Medicine Department/Pulmonary Consult Service, 10 Center Dr, Bldg 10-CRC, Room 3-3677, Bethesda, MD 20892 (munronl@cc.nih.gov). Margaret Ruggiero is Acute Care Nurse Practitioner, National Institutes of Health, Critical Care Medicine Department/Pulmonary Consult Service, Bethesda, Maryland.
authors.forename: Nancy
authors.initials: N
authors.lastname: Munro
authors.forename: Margaret
authors.initials: M
authors.lastname: Ruggiero
mesh_terms: D014487:Centers for Medicare and Medicaid Services, U.S.; D004509:Education, Nursing, Continuing; D006801:Humans; D008484:Medicaid; D053717:Pneumonia, Ventilator-Associated / Q000451:nursing / Q000628:therapy*; D014481:United States