868). List of concerns Ventilator-acquired pneumonia has been linked to increased ventilator time and hospital stays, increased cost, and increased mortality (Vincent, Barros & Cianferoni, 2010, 1927). It is a factual truth that VAP has surpassed all sorts of infection and has been deemed as the foremost cause of death amongst all types of nosocomial infection. Patients often hunt for a treatment or a combination of treatments which are effectual and leads to early recovery. It is very important that facts about the treatment and its efficacy must be communicated to the healthcare settings, staff, family, and patients since staying in the intensive care units is taxing for both the patient and family. Generally, patients go to a hospital which provides a cost-effective treatment and has low occurrence of VAP. Additionally, the effectiveness of the treatment forms the basis of the patients’ selection and decision to continue in that treatment. If the selected treatment does not contribute to patients’ recovery, they are likely to try a combination treatment or a new one. Most importantly, it has been observed that the mortality rates in combination therapies are much lower than in the case of monotherapies. On clinically studying 200 patients with P. aeruginosa bacteremia, it was revealed that the mortality rates for VAP patients undergoing monotherapy was 88% (7 out of 8 patients) whereas rate for those undergoing combination therapy was 35% (7 of 20 patients) (Chastre & Fagon, 2002, p.
892). According to Arroliga et al. (2012), ventilator care bundles are evidence-based practices and multidisciplinary approaches that have significantly contributed in reducing the occurrence of VAP in the United States and in enhancing health outcomes (p. 688). This approach includes a string of evidence based interventions associated to ventilator care such as head elevation, daily sedation, assessment of readiness to extubate, and prophylaxis for peptic ulcer disease and deep vein thrombosis, which when implemented together will achieve significantly better results than when applied separately (Gillespie, 2002, 48). Clinical trials, preferably analyzed together in a meta-analysis, must be conducted in order to resolve the problem of increasing occurrence of VAP in healthcare settings. The purpose of conducting clinical trials is to ascertain the efficacy of each treatment and its combination, and determine which preventive or management strategy best facilitates in reducing ventilator-acquired pneumonia. Furthermore, conducting clinical trials will also determine whether combination treatments are better and cost-effective than single treatments. By researching the issue and developing a correct question, a resolution could be made to improve patient outcomes. Answerable Question PICO question facilitates optimization and application of evidence-based practices. Formulating a PICO-format question is also the first step of an evidence-based practice. In accordance with the problem, purpose, and resolution acknowledged, the author has come up with the research question as follows: P- In ICU adult patients receiving mechanical ventilation after 48 hours I- does combination treatment or ventilator bundles C- compared to traditional single treatment O- lead to reduced incidence of ventilator-acquired pneumonia? Evidence-based resources Some of the most relevant resources for