Implementation and Routinization of the ABCDE Bundle: A Mixed Methods Evaluation.
Background: The ABCDE (Awakening and Breathing Coordination, Delirium monitoring and management, and Early exercise/mobility) bundle has been associated with reductions in delirium incidence and improved patient outcomes but has not been widely adopted. Objective: The objective of this study was to...
| Publicado en: | Dimensions of Critical Care Nursing Vol. 40; no. 6; pp. 333 - 345 |
|---|---|
| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
Nov/Dec2021
|
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=152771321&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 152771321 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 07304625 48N jtl: Dimensions of Critical Care Nursing issn: 07304625 maglogo: N pubinfo: dt: Nov/Dec2021 vid: 40 iid: 6 pid: 5086 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 152771321 152771321 152771321 10.1097/DCC.0000000000000495 152771321 ppf: 333 ppct: 12 formats: tig: atl: Implementation and Routinization of the ABCDE Bundle: A Mixed Methods Evaluation. aug: au: Collinsworth, Ashley W. Brown, Rachel Cole, Louann Jungeblut, Candice Kouznetsova, Maria Qiu, Taoran Richter, Kathleen M. Smith, Susan Masica, Andrew L. affil: Senior Research Scientist, 3M, Medical Solutions Division, Health Care Business Group, San Antonio, TX sug: subj: Implementation Science Quality of Health Care Critical Care Delirium Professional Compliance Evaluation Attitude of Health Personnel Evaluation Human Multimethod Studies Nurses Physicians Psychotherapists Audit Feedback Intensive Care Units Adult Checklists Neuropsychological Tests Interviews Questionnaires Convenience Sample Interview Guides Open-Ended Questionnaires Summated Rating Scaling Semi-Structured Interview Audiorecording Thematic Analysis Content Analysis Conceptual Framework Diffusion of Innovation Unpaired T-Tests Data Analysis Software Adult: 19-44 years ab: Background: The ABCDE (Awakening and Breathing Coordination, Delirium monitoring and management, and Early exercise/mobility) bundle has been associated with reductions in delirium incidence and improved patient outcomes but has not been widely adopted. Objective: The objective of this study was to determine how to facilitate ABCDE bundle adoption by examining the impact of different implementation strategies on bundle adherence rates and assessing clinicians' perceptions of the bundle and implementation efforts. Methods: This study examined the effect of 2 bundle implementation strategies on patient care in 8 adult intensive care units. The basic strategy included electronic health record (EHR) modification, whereas the enhanced strategy included EHR modification plus additional bundle training, clinical champions, and staff engagement. A total of 84 nurses, physicians, and therapists participated in interviews and a survey to assess bundle implementation. Results: Respondents indicated bundle use resulted in "best care" through care standardization and coordination and improved patient outcomes. Intensive care units in both intervention groups had significant improvements in bundle adherence after implementation efforts, but intensive care units in the basic intervention group outperformed other sites after initiating their own implementation strategies. Successful implementation tactics included incorporating the bundle intomultidisciplinary rounds and providing ongoing support, training, and routine auditing and feedback. Discussion: The ABCDE bundle can improve quality of care and outcomes, and implementation can be accelerated through EHR tools, trainings, and performance feedback. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|