3APA Citation:van Nieuewnhoven, C.A., Vandenbroucke-Grauls, C., van Tiel, F.H., Joore, H.C.A., van Schijndel, R.J.M.S., van der Tweel, I., … Bonton, M.J.M. (2006). Feasibiltiy and effects of the semi-recumbent position to prevent ventilator-associated pneumonia: a randomizedstudy.Critical Care Medicine, 34(2), 396-402. Retrieved from ?url=aspx?direct=true&db=mdc&AN=16424720&site=eds-live&scope=siteVariable and key conceptsThe framework of this particular article is to evaluate the effect of patient positioning on the occurrence of ventilator-associated pneumonia. It touches on several factors that can affect the colonization of bacteria while being intubated such as micro-aspiration from enteral feedings.A specific hypothesis was not identified in this particular study.The research question was aimed to determine the preventive effects and feasibility of the semi-recumbent position on the occurrence of ventilator-associated pneumonia in intubated patients. This particular study was performed after the results of a previous study were questionable. The research question was well stated and clear to the reader. SamplingThe participants in this study were adult ICU patients that were mechanically ventilated who met the inclusion/exclusion criteria. Out of 255 eligible participants, 221 were included in the study. Statistical analysis showed that 252 patients would be needed to reject the null hypothesis and 176 would be needed to accept the null hypothesis of no risk reduction. While the sample number was fair, it could have been deemed a higher quality study with a higher number of participants. Four different ICUs in three different university hospitals were utilized for this particular study. Patients eligible for participation were ICU patients that were intubated within 24 hours of ICU admission and had an expected intubation time of at least 48 hours. Patients were not eligible if they were undergoing selective decontamination of the GI tract or if they could not be randomized to one of the two positions studied (semi-recumbent or supine). The study was terminated in forty patients that were intubated less than 48 hours due to extubation, death, the need for prone positioning due to respiratory problems, a newly development contraindication to the set positioning, or transfer to another facility not participating in the study. Design and MethodThe research in this study design is a mixture of quantitative and qualitative. It used numerical data that could be turned into statistics but also used a smaller sample size of whichwere selected based on inclusion and exclusion criteria.The design used was appropriate to answer the stated research question and give insight into the effects of patient positioning and the occurrence of a ventilator-associated pneumonia.