Researchers at Vanderbilt University Medical Center in Nashville, TN, and other institutions assessed the ABCDEF bundle in 2018 and concluded that it “represents one method of approaching the organizational changes that create a culture shift in treatment of ICU patients.”
The benefits outweigh the associated costs and required coordination, the researchers concluded.
“Ultimately, the ABCDEF bundle is one path to well-rounded patient care and optimal resource utilization resulting in more interactive ICU patients with better pain control, who can safely participate with their families and healthcare providers in higher-order physical and cognitive activities at the earliest point in their critical illness,” the researchers said in a study report. (The report is available online at: https://bit.ly/2HMHppw.)
These are some key findings from the report:
• “Assessment of pain is the first step before administering pain relief. The Behavioral Pain Scale (BPS) and the Critical-Care Pain Observation Tool (CPOT) are the most valid and reliable behavioral pain scales for ICU patients unable to communicate.”
• “Coordination of Spontaneous Awakening Trials (SAT) with Spontaneous Breathing Trials (SBT) is associated with decreases in sedative use, delirium, time on mechanical ventilation, and ICU and hospital lengths of stay.”
• “Delirium monitoring and management is critically important because it is a strong risk factor for increased time on mechanical ventilation, length of ICU and hospital stay, cost of hospitalization, long-term cognitive impairment, and mortality.”
• “Early mobility is the only currently known intervention associated with a decrease in delirium duration. Physical therapy is safe and feasible in the ICU, even while on mechanical ventilation, renal replacement therapy, and/or circulatory support.”