A series of fact sheets distributed and posted prominently reinforced staff awareness of proper procedures for minimizing ventilator-associated pneumonia (VAP) at Barnes-Jewish Hospital in St. Louis. The sheets covered five major topics:

1. Risk factors

2. Causes of VAP

3. Decreasing the risk to patients

4. Proper procedure for draining ventilator circuit condensate

5. Collecting a suctioned sputum specimen

Here, for example, are facts contained in sheet #5:

• Wash hands or use waterless antiseptic agent.

• Put on clean gloves.

• Connect suction tube adapter to sputum trap.

• Put on sterile gloves.

• Connect sterile suction catheter to rubber tubing on sputum trap.

• If secretions are thick and tenacious, install small amount of normal saline into endotracheal tube.

• Insert the tip of the catheter into the endotracheal tube or tracheostomy. Do not apply suction. Advance catheter until patent coughs.

• As patient coughs, apply intermittent suction for collection of 2 mL to 10 mL of sputum.

• Remove gloves and wash hands or use waterless hand antiseptic agent.

• Transport specimen within two hours when kept at room temperature or within 24 hours when refrigerated.

Source: Barnes-Jewish Hospital, St. Louis.