Oral Hygiene with Chlorhexidine Ventilator Package and Oral Hygiene Procedures Ventilator-associated pneumonia (VAP) is a healthcare-acquired infection with a concerning risk for patients requiring mechanical ventilation . In fact, VAP is the most common nosocomial infection in mechanically ventilated patients (Barclay & Vega, 2005). The American Association of Critical Care Nurses (AACN) has recommended measures to reduce VAP and, when implemented together, are referred to as the “Ventilator Bundle.” These steps are based on Centers for Disease Control and Prevention (CDC) best practice guidelines and include elevating the head of the bed from 30 to 45 degrees, continuously removing subglottic secretions, changing the ventilator no more than every 48 hours and hand washing before and after contact with the patient (AACN, 2008). In the Guidelines for the Prevention of Healthcare-Associated Pneumonia, 2003, the Centers for Disease Control and Prevention (CDC) also makes a key recommendation for the development of oral health programs that may include the use of an oral antiseptic agent (CDC, 2004). Care procedures in need of change Although oral hygiene is present in the ventilator policies of many intensive care units and used in conjunction with the ventilator package, there is wide variation. In a 2007 cross-sectional survey of critical care nurses, 50% reported having oral hygiene protocols in place in their hospitals but revealed variations in practices (Cason, Tyner, Saunders & Broome, 2007). In 2005 Peace Health St, Joseph's Medical Center, a 243-bed rural hospital in Bellingham, WA formed a comprehensive ventilator package that included oral care. The basis of the practice was determined by a multidisciplinary team trained in… middle of paper… xidine. Retrieved from http://www.ihi.org/knowledge/Pages/Changes/DailyOralCarewithChlorhexidine.aspxIHI. (2011). Fan package. Retrieved from http://www.ihi.org/offerings/MembershipsNetworks/MentorHospitalRegistry/Pages/VentilatorBundle.aspxKoeman, M., AJA, Hak, E., Joore, H., Kaasjager, K., de Smet, A., &, ... Bonten, M. (2006). Oral decontamination with chlorhexidine reduces the incidence of ventilator-associated pneumonia. American Journal Of Respiratory & Critical Care Medicine, 173(12), 1348-1355. Munro, C., Grap, M., Jones, D., McClish, D., & Sessler, C. (2009). Chlorhexidine, toothbrushing, and prevention of ventilator-associated pneumonia in critically ill adults. American Journal of Critical Care, 18(5), 428-438. doi: 10.4037/ajcc2009792.Valente, T. (2002). Evaluation of health promotion programs. New York: Oxford University Press.