Ventilator-associated events have been considered an outcome metric for quality patient care. Ventilator-associated events are associated with unnecessary medical expenses. These events are multifactorial, yet bedside nurses can help decrease this nosocomial infection through proper oral care. A PICOT question was constructed to search the evidence systematically. The systematic literature search evidence was appraised to provide recommendations for the bundle of care process regarding ventilator-associated event prevention, specifically oral care. The body of evidence was comprised of five articles reporting statically significant outcomes. The evidence-based oral care protocol was implemented for a quarter of a year in patients with mechanical ventilation in a pilot unit. Project outcomes were assessed and compared to the body of evidence findings. The project had similar findings to the reported literature: the rate of ventilator-associated events decreased by 31.56%, the length of stay decreased by 43.96%, and ventilator days were reduced by 29.91%. Quality oral care is essential for mechanically ventilated patients to decrease nosocomial infection rates. Oral care provided with a toothbrush or swab, utilizing an antiseptic solution every eight hours with subglottic suction, is effective and will improve patient outcomes. Policy and procedure revisions are warranted after the project's expansion to a generalized acute care population. Continued education and feedback on the oral care process are also necessary.

Date of publication

Spring 4-17-2023

Document Type

DNP Scholarly Project



Persistent identifier


Committee members

Cheryl D. Parker, Lauri D. John, Jenifer Chilton, Barbara Haas


Doctor of Nursing Practice