title: Assessment of Critical Care Provider's Application of Preventive Measures for Ventilator-Associated Pneumonia in Intensive Care Units.
abstract: BACKGROUND
  The implementation of guidelines for the prevention of Ventilator-associated pneumonia has been shown to have a significant effect in reducing the incidence of VAP.
  
  
  OBJECTIVE
  The aim of the present study was to evaluate the implementation of the preventive strategies for VAP in ICUs of university hospitals of Sari, Iran.
  
  
  METHODS
  This cross-sectional study was carried out in 600 beds/day in the ICUs of university hospitals of Sari from April to June 2012. Sampling was done by availability technique in patients receiving mechanical ventilation in the ICU. The implementation of the preventive measures was assessed by a standard checklist with previously approved validity and reliability.
  
  
  RESULTS
  The percentage of implementing each of the measures was as follows: sterile suction, 88.44%; semi-recumbent position, 76.8%; oral hygiene, 58.45%; using heat and moisture exchanges (HMEs), 58%; controlling cuff pressure, 46.8%; hand hygiene, 32.8%; using anti-coagulants, 26.8% and physiotherapy, 25.5%. Closed suction system, continuous drainage of subglottic secretions and kinetic beds were not used at all.
  
  
  CONCLUSIONS
  The overall mean percentage of implementing preventive measures was low and required designing integrated guidelines by considering the conditions of the ICUs in each country, as well as educating and encouraging the staffs to use the recommended guidelines.
authors.affiliation: Faculty, Department of Medical Surgical Nursing, Antimicrobial Resistant Nosocomial Infection Research Center, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Masoumeh
authors.initials: M
authors.lastname: Bagheri-Nesami
authors.affiliation: Critical Care Nurse, Nasibeh Nursing and Midwifery School, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Maryam
authors.initials: M
authors.lastname: Amiri-Abchuyeh
authors.affiliation: Critical Care and Cardiac Anesthesia Fellowship, Associate Professor of Anaesthesiology, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Afshin
authors.initials: A
authors.lastname: Gholipour-Baradari
authors.affiliation: Assistant Professor, Department of Biostatistics, School of Health Sciences, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Jamshid
authors.initials: J
authors.lastname: Yazdani-Cherati
authors.affiliation: Critical Care Nurse, Nasibeh Nursing and Midwifery School, Mazandaran University of Medical Sciences , Sari, Iran .
authors.forename: Attieh
authors.initials: A
authors.lastname: Nikkhah
keywords: Guidelines for preventive measures; ICU staff; Nosocomial infection