What nursing action is most important to help prevent ventilator-associated pneumonia (VAP)?

To prevent ventilator-associated pneumonia (VAP), the focus is on practices that reduce the risk of infections in patients who are mechanically ventilated. One of the most critical nursing actions is careful hand washing and the use of gloves during suctioning. This practice is essential because it directly minimizes the introduction of pathogens into the respiratory tract during suctioning procedures, which can be a common route for bacteria to enter the lungs.

Suctioning is often necessary for patients on ventilators to clear secretions, but it presents a risk for introducing bacteria, especially if proper hygiene protocols are not followed. By emphasizing hand hygiene and protective equipment, healthcare providers create a barrier against infection and significantly contribute to lowering the incidence of VAP.

The other options, while important in their own right, do not have quite the same direct impact on immediate infection prevention during procedures that are most risky for introducing bacteria. Intubation protocols and changing ventilator circuits are important for maintaining equipment and patient safety, and regular oral care plays a role in overall oral hygiene, but hand washing and appropriate glove use during suctioning specifically target one of the key moments where infection risk can be high.