What nursing action reduces the risk of ventilator-associated pneumonia (VAP)?

• A. Daily sedation vacation and assessing readiness to extubate.
• B. Maintaining continuous deep sedation.
• C. Limit oral care to once per day.
• D. Keep the endotracheal tube in place as long as possible.

Answer: (A)

Reducing the time a patient spends on a ventilator lowers the risk of ventilator-associated pneumonia. Daily sedation vacations allow the patient to wake, demonstrate neurological function, and participate in spontaneous breathing trials to assess readiness for extubation. When a patient can be extubated sooner, exposure to the endotracheal tube and ventilator circuit decreases, which reduces opportunities for bacterial colonization and aspiration around the tube. Ongoing deep sedation prolongs ventilation and increases VAP risk; delaying extubation, limiting oral care, or keeping the tube in place longer also increases risk. So, routinely performing a daily interruption of sedation with evaluation for extubation readiness best minimizes VAP risk.