Activity Summary. The ventilator-associated pneumonia (VAP) bundle is a focus of many health care institutions. Many hospitals are conducting process- improvement projects in an attempt to improve VAP rates by implementing the bundle. However, this bundle is controversial in the literature, because the evidence supporting the VAP interventions is weak. In addition, definitions used for surveillance are interpreted differently than definitions used for clinical diagnosis. The variance in definitions has led to lower reported VAP rates, which may not be accurate.