Pediatric-Specific Bundle Offers New Strategies for Preventing Ventilator-Associated Pneumonia in Children

Recommendations published in Critical Care Nurse focus on suctioning or airway clearance, oral care and ventilator circuit changes

Jun 04, 2013, 08:05 ET from American Association of Critical-Care Nurses

ALISO VIEJO, Calif., June 4, 2013 /PRNewswire/ -- Implementation of a bundle for prevention of ventilator-associated pneumonia (VAP) in critically ill infants and children may lead to lower rates of VAP in these patients, according to an article in the June issue of Critical Care Nurse (CCN).

VAP, the second most common hospital-associated infection in pediatric intensive care units, is linked to increased morbidity, mortality and lengths of stay in the hospital and intensive care unit, adding tremendously to healthcare costs. Prevention is the most appropriate intervention, but no official guidelines have been published for VAP prevention in infants and children, and little research has been done in children to guide bedside care.  

The article, titled "Preventing Ventilator-Associated Pneumonia in Children: An Evidence-Based Protocol," assembles evidence-based practice recommendations and integrates pediatric-specific interventions with a proven adult model to propose new strategies bedside nurses can implement to prevent this important healthcare problem.

The bundled prevention protocol for support of infants and children receiving mechanical ventilation focuses on suctioning or airway clearance, ventilator circuit changes and oral care.

Researchers Virginia Cooper, RN, MS, and Catherine Haut, DNP, CPNP/AC, CCRN, developed the recommendations. Cooper practices as a nurse in the pediatric intensive and intermediate care units at the University of Maryland Medical Center, Baltimore. Haut is the program director of the acute care pediatric nurse practitioner program at the University of Maryland School of Nursing and practices as a pediatric nurse practitioner in the pediatric intensive care unit at Herman & Walter Samuelson Children's Hospital at Sinai, Baltimore.

"Critical care nurses play an important role in identification of risk factors and prevention of ventilator-associated pneumonia," Cooper said. "The care bundle we propose offers evidence-based alerts and consistent prevention strategies for providers caring for children in the pediatric intensive care unit."

The researchers also call for additional research to document the effectiveness of bedside protocols to prevent VAP in infants and children. Maintaining data collection over time with the use of the VAP bundle will supply critical information on the effectiveness of these nursing and respiratory interventions in changing the incidence of VAP in a particular setting.

Access the article abstract and full-text PDF by visiting the CCN website at

About Critical Care Nurse: Critical Care Nurse (CCN), a bimonthly clinical practice journal published by the American Association of Critical-Care Nurses, provides current, relevant and useful information about the bedside care of critically and acutely ill patients. The journal also offers columns on traditional and emerging issues across the spectrum of critical care, keeping critical care nurses informed on topics that affect their practice in high acuity, progressive and critical care settings. CCN enjoys a circulation of more than 100,000 and can be accessed at

About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, Calif., the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN joins together the interests of more than 500,000 acute and critical care nurses and claims more than 235 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.

American Association of Critical-Care Nurses, 101 Columbia, Aliso Viejo, CA 92656-4109;
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SOURCE American Association of Critical-Care Nurses