Preventing and treating VAP continues to be a major challenge for critical care staff. In order to improve quality and safety and reduce complications of critical care, such as VAP, simple pragmatic definitions are required for clinicians to work with outside of formal research trials. It appears that disagreement over a definition of VAP remains a major issue for many (Wong et al., 2012) whilst our adoption of a simple pragmatic definition has allowed progress to be made and clear improvements to be demonstrated.