Salamonson Y, Kariyawasam A, van Heere B, O'Connor C. The evolutionary process of medical emergency team (MET) implementation: Reduction in unanticipated ICU transfers. Resuscitation. May 2001;49(2):135-141.

This article describes a study to determine whether the introduction of the Medical Emergency Team (MET) system designed to provide immediate help for seriously ill patients: 1) changed the pattern of ICU patient transfers from the wards; and 2) improved hospital survival rates.

Besserman E, Teres, D, Logan A, Brennan P, Cleaves S, Bayly R, et al. Use of flexible intermediate and intensive care to reduce multiple transfers of patients. American Journal of Critical Care. 1999;8(3):170-179.

Described here is a method for small-cycle quality improvement: Plan-Do-Study-Act. Mostly concentrates on Adult Intensive Care Unit and the IHI Breakthrough Series.

Van den Berghe G, Wouters PJ, Bouillon R, et al. Outcome benefit of intensive insulin therapy in the critically ill: Insulin dose versus glycemic control. Critical Care Medicine. 2003;31(2):359–366.

This article identifies metabolic control as the strongest contributor to the improved outcomes associated with intensive insulin therapy.

Resar R, Pronovost P, Haraden C, Simmonds et al. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Joint Commission Journal on Quality and Patient Safety. 2005;31(5):243-248.

The implementation of four evidence-based clinical interventions in the treatment of mechanically ventilated patients (the "ventilator bundle") reduces the risk of ventilator-associated pneumonia, thus reducing the rate of critically ill patient’s mortality and morbidity.

Simmons-Trau D, Cenek P, Counterman J, Hockenbury D, Litwiller L. Reducing VAP with 6 Sigma. Nursing Management. 2004;35(6):41-45.

Illinois-based OSF Saint Francis Medical Center integrates 6 Sigma methodologies to reduce rates of ventilator-associated pneumonia. 

Houston S, Hougland P, Anderson JJ, LaRocco M, Kennedy V, Gentry LO. Effectiveness of 0.12% chlorhexidine gluconate oral rinse in reducing prevalence of nosocomial pneumonia in patients undergoing heart surgery. American Journal of Critical Care. 2002;11(6):567-570.

Nosocomial pneumonia rates for patients undergoing aortocoronary bypass or valve surgery requiring cardiopulmonary bypass were significantly reduced for patients intubated for more than 24 hours when treated with 0.12% chlorhexidine gluconate oral rinse (Peridex). 

Brennan MT, Bahrani-Mougeot F, Fox PC, Kennedy TP, Hopkins S, Boucher RC, Lockhart PB. The role of oral microbial colonization in ventilator-associated pneumonia. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, Endodontology. 2004;98(6):665-672.

This article discusses the association between prior microbial colonization of the oral cavity and the occurrence of ventilator-associated pneumonia in critically ill patients in the intensive care unit.

Deshpande KS, Hatem C, Ulrich HL, et al. The incidence of infectious complications of central venous catheters at the subclavian, internal jugular, and femoral sites in an intensive care unit population. Critical Care Medicine. 2005;33(1):13-20.

Selection of site placement for central venous catheters does not lead to increased rate of infection when confounding factors are controlled.

Berenholtz SM, Pronovost PJ, Lipsett PA, et al. Eliminating catheter-related bloodstream infections in the intensive care unit. Critical Care Medicine. 2004;32(10):2014-2020.

Catheter-related blood stream infections have been nearly eliminated in one intensive care unit through the implementation of five interventions based upon evidence-based infection control guidelines.

Rello J, Lorente C, Bodi M, Diaz E, Ricart M, Kollef MH. Why do physicians not follow evidence-based guidelines for preventing ventilator-associated pneumonia? A survey based on the opinions of an international panel of intensivists. Chest. 2002;122(2):656-661.

This paper describes the findings of a survey of 110 “opinion leaders on VAP” from 22 countries.  Respondents were asked to indicate which of 33 evidence-based interventions for the prevention of ventilator-associated pneumonia (VAP) had been implemented in their ICUs.  While the overall implementation rate was reported to be only 80.4 percent, reported implementation rates were higher for those interventions with better evidence regarding effectiveness, including semirecumbent positioning (91.8 percent) and removal of the endotracheal tube as soon as clinically feasible (100 percent).