There are a number of effective pharmacologic and nonpharmacologic interventions available to clinicians for the prevention of VAP.14Developing a VAP prevention program for use in a specific ICU should be based on careful consideration of the following factors. Focused infection control efforts with buy-in from all patient-care providers (physicians, nurses, respiratory therapists) are most likely to be successful.15The selection of interventions for a VAP prevention program depends on the available patient staffing, administrative resources, and the ability of the unit or infection control group to tract compliance with the program over time. Several studies16–18 have shown the importance of unit staffing on compliance with interventions, such as hand washing and ventilator weaning, which should decrease the incidence of nosocomial infections. In units with suboptimal staffing, interventions requiring minimal effort from bedside nurses and respiratory therapists may be most applicable (eg, semirecumbent patient positioning, alcohol foam and gels for hand disinfection, subglottic drainage). Additionally, the influence of interventions on patient outcomes should be tracked over time to determine their success and cost-effectiveness.,12–13 This will help to determine whether these interventions should be continued and whether erosion in compliance with the VAP prevention program has occurred. The latter may necessitate further education and training of unit staff or implementation of alternative interventions to improve the effectiveness of the infection control program.