• Background Oral care and head-of-bed elevation are interventions to decrease risk of aspiration pneumonia in hospitalized patients. In a previous study, nurses’ self-reports of how often they performed oral care did not match documented provision of such care. • Objectives To replicate the original study and estimate instrument reliability. • Methods A cross-sectional design was used, and survey data from nursing personnel and bedside observational data from 9 intensive care units were collected. • Results A total of 181 surveys (47%) were returned, and data were collected from 436 bedsides. Reported frequencies of oral care and use of oral care products differed between nonintubated and intubated patients (P<.001). The mean documented frequency of oral care for nonintubated patients was 1.8 (SD 1.5); self-reported frequency was 3 (SD 2.4). The mean documented frequency of oral care for intubated patients was 3.3 (SD 1.8); self-reported frequency was 4.2 (SD 2.1). Documented oral care frequency differed by unit (P = .006) and intubation status (P < .001). Mean observed head-of-bed position was 38° (SD 24°) for nonintubated patients and 23° (SD 12°) for intubated patients (P < .001). Intubation status, but not unit, affected observed head-of-bed position (P < .001). Three survey items had adequate reliability evidence (r=0.70). Interrater reliability for bedside data collection was 96% or greater. • Conclusions Despite inadequate estimates of survey reliability, findings generally were comparable to results of the original study; nurses report more frequent oral care than is documented. Intensive care nurses elevate the head of patients’ beds in accordance with self-reports.

Turning critically ill, mechanically ventilated patients every 2 hours is a fundamental nursing intervention to reduce the negative impact of prolonged immobility from preventable pulmonary complications such as ventilator-associated pneumonia and atelectasis. Unfortunately, when coupled with positive pressure ventilation, the benefits of turning may come at the expense of cardiovascular function. Clinicians should closely monitor the hemodynamic response to turning mechanically ventilated patients, and if compromise is observed, the degree and duration of compromise may provide guidance to the appropriate intervention.