With respect to the article by Labeau et al,1 we believe that development of a questionnaire to accurately evaluate nurses’ knowledge of current ventilator-associated pneumonia (VAP) guidelines is an admirable pursuit. Appreciating the knowledge gap in this area is crucial as healthcare and medicine continue to advance. The incidence of VAP and related morbidity and mortality can be reduced by preventive measures such as those mentioned in the article (eg, semirecumbent positioning, circuit changes).

In our coronary care unit at a tertiary hospital in upstate New York, we implemented a similar plan, monitoring nursing compliance with strategies for reducing the prevalence of VAP. Only through chart reviews and interviewing staff members did we discover that unassisted ventilator trials (UVTs) were not routinely being performed for patients who needed them; in fact, only 70% of ventilated patients who qualified were receiving this recognized preventive measure. When we realized that 30%...

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