To meet the competency standards of practice and to remain accountable in practice are very important aspects of nursing care. The main reason the patients on ventilator needs to be monitored and managed with dexterity is ventilator associated pneumonia (VAP), which adds to the morbidity and mortality statistics associated with ventilator management and hence this condition needs to be prevented. The current practice in the United States is to use the ventilator bundle as a nursing guideline for practice in the intensive care unit with focus remaining on the head of the bed elevation (Tolentino-DelosReyes et al., 2007). As has been indicated by Reeve and Cook (1999), VAP is the most serious complication of critical illness, and this occurs not due to the illness per se, but due to management of the patient. The magnitude of the problem will be more relevant from the fact that this accounts for almost half the intensive care unit infections in Europe (Vincent et al., 1995). A guideline for care in the current practice as a specialist nurse in a district hospital would be the best tool, and such tools can be accomplished through the evidence base. This would involve a way to improve current practice through the critical and thoughtful integration of best available evidence from research into clinical practice (Manthous et al., 1998). Research is a systematic enquiry on any subject, and therefore, research in the area of intensive care nursing relevant to people receiving ventilator breathing would mean a process to answer questions relevant to practice in this area (Cormack 2000).
This has an implication for the nurse involved in clinical practice, and it is required by the standards of practice that the nurse involved in practice expansion must ensure that the practice is evidence based and can be justified in the literature. Price (2001) states that a thorough literature review provides a foundation on which to base new knowledge and usually is conducted