Cost-effective application of the Centers for Disease Control Guideline for Prevention of Nosocomial Pneumonia.

Some parts of the Guideline are clearly cost-effective. Abandoning routine cultures of respiratory therapy equipment is cost-effective and should be adopted by any hospitals that have not done so already. Other practices such as the use of preoperative and postoperative instructions regarding deep breathing and incentive spirometry, and the policy of never reusing respiratory therapy equipment items that are intended for single use probably warrant further cost-benefit analysis. Finally, there is increasing evidence that changing ventilator tubing every 24 hours is not cost-effective. Changing tubing every 48 hours appears to be safe and can save hospitals substantial sums of money.