Please fallow the guide line that I have attached and the paper is supposed to be written based the research article and it is a critique and please make sure its four pages thank you!! Descriptive Vividness The purpose of the study was to establish the effect of nurse patient ratio related to risk for ventilator associated pneumonia in ICU patients. The intent of the article was clearly identified. The author described the study adequately. The article includes very detailed statistical data about patient nurse ratio. However, there was no clear description about the number of nurses participated in the research. The study was well articulated and informal to the nursing team. Documentation of Participants The participants were ICU patients from 9 European countries. Total samples of 2585 patients were included in the study. The article stated that all participants were admitted in the ICU for the treatment of pneumonia or received 48 hours or more invasive mechanical ventilation. The researcher did not include information about the difference in ICU settings used in the research study. The study also illustrated that in addition to nurse to patient ratio, patients admitted to the hospital with trauma, the length of stay in the ICU and the acuteness of the disease played a vital role when it comes to acquiring ventilator associated pneumonia. It was indicated in the research study that there was no evident proof to show how 1:1 nurse patient ratio prevents ventilator associated pneumonia. Methodological congruence The researcher provided appropriate statistical evidence. Even if a total number of 2585 patients were included in the study, 927 of the patients did not provide information about the nursing staff, only 1658 patients were included in the research study. Even though the patient nurse ratio was 1:1 in most ICU settings 393(27%) of them developed ventilator associated pneumonia during their treatment. The percentage showed a significant difference in relation to patient nurse ratio 1:1 were 9.3% and 3:1 were 24.2%. However, the researcher did not include any interaction or interview that was done with the patient during the study. When it comes to nosocomial Ventilator associated pneumonia the researchers suggested that there were other evident circumstances that needs to be considered in addition to the nurse patient ratio. Ethical Standard The research did not implicate any ethical standard about the patients who participated in the study other than being ICU patient. There was no indication of signing any kind of consent for the purpose of the research study. Especially when patients are on a mechanical ventilator they might have loss of consciousness therefore can not make a decision for themselves. The researcher de-identity the patients identification information for confidentiality purpose. Auditability The conclusion towards the result was clear and concise. There was a clear link between the data and result of the research article. The researcher includes brief statistical data in comparison to nurse patient ratio in the ICU setting. The result obtained from the research was clearly recognized and proved complete accurate information about the result. Analytical and Interpretative Preciseness The researchers examined the relation between patients to nurse ratio and gave a clear evident statistical data in relation to ventilator associated pneumonia. It was implicated in the article that 1:1 patient nurse ratio was associated with lower risk for ventilator associated pneumonia. Researchers also included other risk factors that leads to ventilated associated pneumonia which includes level of trauma, the length of stay in a hospital ,and the severity of the disease condition. Philosophical/Theoretical Connectedness The article clearly acknowledged the relation between nurse to patient ratio. The researchers indicated that there are other risk factors that needs to be considered in addition to nurse patient ratio which includes admission because of trauma, the length of stay in the hospital, and the disease severity of patient on mechanical ventilator. Even Though the nurse patient ratio has an impact on patient care the nurse`s ability to provide proper patient care is more critical when it comes to preventing any hospital acquired infection during treatment including ventilator associated pneumonia. Heuristic Relevance The researcher clearly identified the cause and effect of the study. The researcher used significant numeric information including the percentage on how many patients get ventilator associated pneumonia during hospital stay. The author stated that 27% of ICU patients were infected with ventilator associated pneumonia which showed that nurses need to pay a close attention treating ventilated patient and provide appropriate nursing care to prevent any hospital acquired infections. In addition, nurses needs to be well educated about the risk factor of ventilated patient to prevent other complications. Strength of the Research Article The author showed a clear statistical data about nurse-patient ratio in ICU setting. The number of participants was significant to analyze the clinical data. The researcher used different analytical techniques to analyze the data. The study presented the characteristic of patients receiving mechanical ventilation in a table format for a clear understanding. In addition, a brief presentation was provided in the article to show days of mechanical ventilation until the onset of pneumonia and the total duration of ventilation for patients on how ventilator associated pneumonia did not develop. Also the author was able to include other related researches done in New York and California. Over all the research was easy to follow throughout the article, it was very appealing to read for any health care professional. Weakness of the research Article The author did not include any background or follow up information about ICU patients. In addition, there was no information provided about the severity, complication or any other comorbidities about the patient`s condition. The researcher did not indicate any timeframe on when the research was done, or how long the research took place. The researcher included the number of patients participated in the study however, the researcher failed to include the number of nurses participated in the research including their educational level and number of years experience in the ICU. The researcher did not inform the participants about the purpose and the objective of the study. Conclusion To conclude, the article was very descriptive and informational. The author implicated that ventilator associated pneumonia is the most common hospital acquired infection in ICU patients. The researchers indicated the significance of high staffing, and its role in minimizing the risk of acquiring nosocomial infection. The author included all relevant information to gather the attention of the reader in relation to ICU nurses and ventilator associated pneumonia. In addition to the ratio between nurses to patient, the author gave the reader information about other circumstances that can influence on acquiring ventilator associated pneumonia which includes the length of stay in ICU, the severity of the disease and the level of trauma. This study has a great nursing implication indicators. As bedside nurses it is important to do appropriate oral care and follow the hospital`s oral care protocol to prevent ventilator associated pneumonia (VAP).. Most importantly implementing evidence based practice to reduce aspiration and other risk factors that lead to VAP. Although the author recommended 1:1 nurse patient ratio lower the risk of getting ventilator associated pneumonia, further study needs to be done in the future