Ventilator-associated pneumonia (VAP) is a preventable secondary consequence of intubation
and mechanical ventilation. VAP is pneumonia that develops in an intubated patient after 48 hours
or more of mechanical ventilator support. Mechanically ventilated patients in neurologic and other
intensive care units (ICUs) are at an increased risk of VAP due to factors such as decreased level of
consciousness; dry, open mouth; and microaspiration of secretions. VAP can be prevented by initiating
interventions from the Institute of Healthcare Improvements VAP bundle, including (a) elevating the
head of the bed of ventilated patients to 30?, (b) preventing venous thromboembolism through use of
sequential compression devices or anticoagulation, (c) administering gastric acid histamine
2
blockers,
(d) practicing good hand hygiene, (e) initiating early mobilization, and (f) performing daily sedation
interruption at 10 am to evaluate neurologic status.
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