Title: Implementation of ABCDEF care bundle in the intensive care units of private tertiary hospitals: A cross sectional study
Purpose: The study aimed to assess the implementation of ABCDEF care bundles in the intensive care units of two private tertiary hospitals.
Background: The awakening and breathing coordination of daily sedation and ventilator removal trials, delirium monitoring and management, and early mobility and exercise and assessment, prevent and manage pain, both spontaneous awakening and spontaneous breathing trials, choice of analgesia and sedation, assess, prevent and manage delirium, early mobility and exercise, family engagement ABCDEF bundles are part of the science of the liberation of the intensive care unit (ICU).
Method: Descriptive cross-sectional research design was used in this study and employed a sample size of 130 using a non-probability convenient sampling technique. Nurses working in the intensive care units of Dr. Soliman Fakeeh Hospital (DSFH) and International Medical Center (IMC) were selected to participate in the current study.
Result: It is reported that nurses use a scale to assess pain in the ICU. However, there were 46.1% nurses reflected on the use visual analogue scale. The use of spontaneous breathing trails question was very positive and all nurses have documented. It is also revealed that 53.8% of nurses used the Riker Sedation-Agitation Scale compared to 46.2% who used Richmond Agitation-Sedation Scale. Furthermore, more than half of nurses assess and monitor delirium in the clinical area at least one time. However, 30.9% of nurses did not do monitor delirium at all. And 69.2% of nurses mobilize patients continuously to combat muscle weakness compared to only 30.8% of nurses who only mobilize to non-ventilated patients. Just more than the half of the nurses explained to the family members the delirium compared to 46.2% of the study participants did not discuss the delirium with family members.
Conclusion: Although most of the surveyed ICUs implemented pain and sedation assessments, many of them did not implement structured delirium assessments. Early mobilization programs and family participation should be encouraged. The results of this study could guide patients and healthcare practitioners particularly nurses in the ICU by helping to facilitate evidence-based shared care decision making with ABCDEF bundle.
Audience Take Away:
- The ABCDEF bundle directs comprehensive patient care and efficient resource use, resulting in more interactive ICU patients with better pain control who may engage in higher-order physical and mental activities without risk at the early stage of their critical illness.
- The audience will be able to understand and implement ABCDEF bundles among all critical care patients and monitor the outcomes.
- This help the audience by:
- Assess, prevent, and manage the pain.
- Spontaneous awaking trail (SAT) and spontaneous breathing trail(SBT).
- Choice of analgesia and sedation.
- Assess, prevent and manage delirium.
- Early mobility and exercise.
- Family engagement and empowerment.
- The research checklist conducted in two private tertiary hospitals, it can be implemented.
- It is simplifying the work for critical care nurses by providing systematic assessment and improve patient outcome.
- It provides a new information about the delirium score which wasn’t implemented before.
- (a)Awareness about the Delirium score.
(b)Can be utilized in another facility.
(c)Helps in weaning protocol.
(d)Early mobility and exercise. List all other benefits.