Introduction/Background Ventilator-associated pneumonia (VAP) is a very common hospital-acquired infection, especially in pediatric intensive care units, ranking as the second most common (Leaf, Meier and Elward, 2007). It is defined as pneumonia that develops 48 hours or more after starting mechanical ventilation. VAP is diagnosed when a chest x-ray shows a new or increasing infiltrate and two or more of the following symptoms: fever > 38.3°C, leukocytosis > 12x10 9 /mL and purulent tracheobronchial secretions (Koenig & Truwit, 2006) . VAP occurs when microorganisms are introduced into the sterile lower respiratory tract and lung parenchyma by aspiration of secretions, migration of the aerodigestive tract, or contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of mechanically ventilated patients in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial to the patient or the healthcare organization. VAP contributes to an increased healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increased length of stay, morbidity and high mortality rates of 20-50% (Foglia et al., 2007) (Craven & Hjalmarson, 2010). Currently, the PICU has implemented all parts of the VARI package except the daily extubation readiness discussion. The VARI package currently includes: bed head greater than or equal to 30 degrees, use of oral antiseptics (chlorhexidine) every morning, oral treatments every 2 hours, etc. In pediatric intensive care units, rates for VAP have decreased since the implementation of safety ro...... half of the paper ...... have shown that by increasing training or explaining the rationale to doctors, it is more they are likely to follow the protocol. To initiate a culture that enables those who are at risk to It is particularly necessary to ensure that VAPs carefully follow safety standards and that education is implemented on those who are at high risk. High-risk patients will also be notified on the home screen on a banner in EPIC, ensuring that extra precautions are taken. The charge nurse will determine the patient as high risk. Once the education plan is implemented, hopefully there will be a positive outcome in the training. A long-term goal is to see if the rate of VAP onset in high-risk patients decreases. Overall, VAP is a preventable infection and by increasing education, surveillance, and adding missing standards to the VARI standards, rates will continue to decline. diminish.