Critical care nurses' role in implementing the "ABCDE bundle" into practice

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A new effort to improve care for ICU patients reveals that a bundle of practices, employed by a nurse-led interprofessional team of health care providers, could help ICU patients avoid delirium and weakness so they heal sooner and are healthier after leaving the hospital. The implementation of these practices was conducted by an interprofessional team, examining a bundle of evidence-based practices called the Awakening, and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility bundle (ABCDE bundle).

The ABCDE bundle uses the best available evidence on delirium, immobility, sedation and analgesia, and ventilator management in the ICU. It is a bundle of interventions tested in clinical trials that have been adapted for everyday use in the ICU. The bundle is founded on three primary principles: improving communication among members of the ICU team; standardizing care processes; and breaking the cycle of oversedation and prolonged attachment to a ventilator that can lead to delirium and weakness.

The article describes how to implement the bundle, and the roles of each member of the team providing care to patients in the ICU, with particular attention to central role of the nurse.

Citation

Balas MC, Vasilevskis EE, Burke WJ, Boehm L, Pun BT, Olsen KM, Peitz GJ, Ely EW. Critical care nurses' role in implementing the "ABCDE bundle" into practice. Crit Care Nurse. 2012 Apr;32(2):35-8, 40-7; quiz 48.

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