Major articleA systematic approach for developing a ventilator-associated pneumonia prevention bundle

•A new ventilator-associated pneumonia prevention bundle using a systematic approach to elicit clinician perceptions on potential interventions for ventilator-associated pneumonia was developed.•There were 65 potential interventions identified through an extensive literature review.•A 2-step Delphi method was implemented to gain consensus on the final list of interventions.•There were 155 clinicians with expertise and interest in ventilator-associated pneumonia treatment and prevention who participated in the process of consensus development.•There were 5 process and 14 structural or policy-driven interventions identified.

BackgroundVentilator-associated pneumonia (VAP) is among the most common type of health care-associated infection in the intensive care unit and is associated with significant morbidity and mortality. Existing VAP prevention intervention bundles vary widely on the interventions included and in the approaches used to develop these bundles. The objective of this study was to develop a new VAP prevention bundle using a systematic approach that elicits clinician perceptions on which interventions are most important and feasible to implement.MethodsWe identified potential interventions to include through a review of current guidelines and literature. We implemented a 2-step modified Delphi method to gain consensus on the final list of interventions. An interdisciplinary group of clinical experts participated in the Delphi process, which was guided by a technical expert panel.ResultsWe identified 65 possible interventions. Through the Delphi method, we narrowed that list to 19 interventions that included 5 process and 14 structural measures.ConclusionsWe described a structured approach for developing a new VAP prevention bundle. Obtaining clinician input on what interventions to include increases the likelihood that providers will adhere to the bundle.