The nurse caring for mechanically ventilated clients uses best practices to prevent ventilator-associated pneumonia. What actions are included in this practice? Select all that apply

A. Adherence to proper hand hygiene is correct because hand hygiene is one of the most effective measures to prevent healthcare-associated infections, including ventilator-associated pneumonia (VAP). Proper handwashing or use of alcohol-based sanitizer before and after patient contact reduces transmission of pathogens. B. Administering a prescribed proton pump inhibitor is incorrect because proton pump inhibitors (PPIs) reduce stomach acidity, which can actually increase the risk of VAP by allowing colonization of the gastrointestinal tract with pathogenic bacteria that can be aspirated into the lungs. C. Elevating the head of the bed is correct because keeping the head of the bed elevated at 30–45° reduces the risk of aspiration of gastric contents, a major contributor to VAP. D. Providing oral care per protocol is correct because oral hygiene with antiseptic solutions (e.g., chlorhexidine) decreases colonization of pathogenic bacteria in the oropharynx, lowering the risk of ventilator-associated pneumonia. E. Suctioning the client every hour is incorrect because routine or frequent suctioning is not recommended and can increase trauma or introduce infection. Suctioning should be performed as needed based on assessment of secretions. F. Turning and positioning the client at least every 2 hours is correct because frequent repositioning helps mobilize secretions, prevent pooling of fluids, and reduce the risk of atelectasis and infection, which can contribute to VAP.