The effects of VAP on morbidity,
mortality, length of hospital stay,
and cost are immense. Education
plays a key role in the management
of patients with VAP. Use of self-study
education modules on the nursing
care of patients at risk for VAP can
decrease the rate of this type of
pneumonia, the number of days of
mechanical ventilation, and the cost
of the disease.8
Healthcare systems can also play
a role in preventing VAP by employing
outcome managers to provide a
more comprehensive approach to VAP
prevention. In one study,42 the duration
of mechanical ventilation, hospital
and intensive care unit lengths
of stay, and mortality decreased
when an outcome manager was used.
Outcome managers can be responsible
for ensuring that protocols to
prevent VAP and other complications
of intubation and mechanical
ventilation are developed and are
being followed appropriately. The
use of ventilator pathways and/or
protocols with preprinted order sets
(Figure 2) can also lead to improved
outcomes for patients. A simple, yet
cost-effective way to ensure compliance
with elevating the head of the
bed is random daily audits. The
rationale for why a patient cannot