Dodek P, Keenan S, Cook D, et al. Evidence-based clinical practice guideline for the prevention of ventilator-associated pneumonia. Annals of Internal Medicine. 2004;141(4):305-313.

A clinical practice guideline written by the Joint Planning Group of the Canadian Critical Care Trials Group and the Canadian Critical Care Society. The guidelines were generated after a systematic search of MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews for al relevant randomized controlled trials that involved mechanically ventilated adults published up until 1 April 2003.

Craven DE, Steger KA. Nosocomial pneumonia in mechanically ventilated adult patients: Epidemiology and prevention in 1996. Semininars in Respiratory Infection. 1996;11(1):32-53.

Review of the epidemiology and causative factors for ventilator-associated pneumonia, concluding that aspiration of gastric contents is a major risk factor.

Collard HR, Saint S. Chapter 17: Prevention of Ventilator-Associated Pneumonia. IN: Agency for Healthcare Research and Quality. Making health care safer: a critical analysis of patient safety practices. http://www.ahrq.gov/clinic/evrptfiles.htm#ptsafety. Accessed 19 January 2005.

A detailed literature review, performed by the University of California at San Francisco (UCSF)-Stanford University Evidence-Based Practice Center, of published research on prevention of ventilator-associated pneumonia, sponsored by AHRQ and published in July 2001.

Center for disease Control and Prevention. Guidelines for preventing health-care-associated pneumonia, 2003 recommendations of the CDC and the Healthcare Infection Control Practices Advisory Committee. Respiratory Care. 2004;49(8):926-939.

This is an abridged version of the full CDC guidelines, and includes correction of errata in that report.

Babcock HM, Zack JE, Garrison T, et al. An Educational intervention to reduce ventilator-associated pneumonia in an integrated health system. A comparison of effects. Chest. 2004;125:2224-2231.

An observational study in 4 hospitals before and after implementation of a 10-page educational self-study modular educational program on best practice for prevention of ventilator-associated pneumonia. Rates of ventilator-associated pneumonia fell overall, but no reduction in rate was seen in the hospital with the lowest rate of module completion amongst respiratory therapists.

American Thoracic Society. Guidelines for the management of adults with hospital acquired, ventilator-associated, and healthcare-associated pneumonia. American Journal of Respiratory Critical Care Medicine. 2005;171(4):388-416.

Updated guidelines from the American Thoracic Society and the Infectious Diseases Society of America. Although these guidelines focus on treatment of established ventilator-associated pneumonia, there is also an up-to-date discussion of modifiable risk factors and a series of recommendations for practices that will reduce the risk; these include use of protocols to improve sedation use and to accelerate weaning and nursing patients in the semirecumbent position.

McCarthy D. Case Study: Improving ICU Care at the Porter Valparaiso Hospital Campus. Quality Matters: December Update from The Commonwealth Fund. December 2004.

This community hospital dramatically improved the quality and safety of care for ICU patients through an evidence-based collaborative improvement model. The hospital's critical care team reduced patient infections, achieved better glucose control, had fewer mortalities, and experienced shorter hospital stays.

Henneman EA, Cardin S. Family-centered critical care: Aa practical approach to making it happen. Critical Care Nurse. Dec 2002;22(6):12-19.

This article describes some techniques and tips on getting support and buy-in for open visiting hours based on a family-centered care model. 

Berwick DM, Kotagal M. Restricted visiting hours in the ICU: Time to change. Journal of the American Medical Association. Aug 2004;292(6):736-737.

In this article, Berwick and Kotagal assert that restricting visiting in ICUs is neither caring, compassionate, nor necessary.

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Chan PK, Fischer S, Stewart TE, et al. Practicing evidence-based medicine: The design and implementation of a multidisciplinary team-driven extubation protocol. Critical Care. 2001;5(6):349-354.

This article is about determining whether extubation is a useful advancement in liberating patients from mechanical ventilation.