Critical care nurse · 2024
Reigniting Intensive Care Unit Liberation.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Guest Margaret, Craven Kevin, Tellson Alaina M, Porter Marlene, James Nakeitha, Turley Lisa, Smitherman Jeremy
Аннотация
BACKGROUND: The Society of Critical Care Medicine has established guidelines to manage pain, sedation, delirium, immobility, family participation, and sleep disruption in the intensive care unit, a set of interventions known as the intensive care unit liberation (ABCDEF) bundle. Adherence to these guidelines has shown positive results.
LOCAL PROBLEM: In the intensive care units of a level I trauma academic teaching hospital in central Texas, the rate of bedside nursing staff adherence to the ABCDEF bundle was only 67.1% in January 2022. The aim of this quality improvement project was to improve adherence to the bundle.
METHODS: Knowledge gaps were found to be the driver of the low adherence rate. Two primary needs were identified: (1) education on the elements of the ABCDEF bundle and (2) increased awareness and recognition of incomplete and incorrect documentation. Interventions included focused education on intensive care unit liberation.
RESULTS: From February to June 2022, overall adherence to the ABCDEF bundle increased from 67.1% to 95.3%, ventilator use decreased by approximately 10%, and restraint use dropped by about 9%. The incidence of delirium increased, but this increase was due to incorrect patient assessment before the interventions.
CONCLUSION: The results of this project are consistent with literature demonstrating that a multifaceted approach to improving ABCDEF bundle adherence can produce sustainable improvement in patient outcomes. This report may help other organizations facing similar challenges improve adherence to the bundle in a postpandemic environment.
LOCAL PROBLEM: In the intensive care units of a level I trauma academic teaching hospital in central Texas, the rate of bedside nursing staff adherence to the ABCDEF bundle was only 67.1% in January 2022. The aim of this quality improvement project was to improve adherence to the bundle.
METHODS: Knowledge gaps were found to be the driver of the low adherence rate. Two primary needs were identified: (1) education on the elements of the ABCDEF bundle and (2) increased awareness and recognition of incomplete and incorrect documentation. Interventions included focused education on intensive care unit liberation.
RESULTS: From February to June 2022, overall adherence to the ABCDEF bundle increased from 67.1% to 95.3%, ventilator use decreased by approximately 10%, and restraint use dropped by about 9%. The incidence of delirium increased, but this increase was due to incorrect patient assessment before the interventions.
CONCLUSION: The results of this project are consistent with literature demonstrating that a multifaceted approach to improving ABCDEF bundle adherence can produce sustainable improvement in patient outcomes. This report may help other organizations facing similar challenges improve adherence to the bundle in a postpandemic environment.