Here is a chart that can hopefully help with pronunciation of the Chamorro letters. While most Chamorros are very forgiving when someone mispronounces the words, there are some cases where mispronunciation leads to confusion and miscommunication, so I'll try to give some pointers on pronunciation.
Healthcare-associated pneumonia (nosocomial pneumonia) is pneumonia that you get when you are in a hospital or nursing home. Experts generally consider it a more serious illness than pneumonia that people get in daily life (community-associated pneumonia). This is because the person with healthcare-associated pneumonia may already have a serious illness. Healthcare-associated pneumonia is also often caused by bacteria other than Streptococcus pneumoniae, which causes most cases of pneumonia.
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.