Discussion and Conclusions: Compliance with recommended lung protective parameters in the
absence of standardized monitoring and intervention protocols is suboptimal. Preliminary evidence of
positive relationships between monitoring and both severity of illness and therapeutic intervention was
established. Control for nursing and physician practice variation is needed to rule out the influence of
surveillance and performance bias on collaborative practice outcomes. Explicit standardized protocols that
address the frequency of assessments and interventions along with therapeutic targets are recommended
for collaborative practice guidelines.