Common Challenges to Effective ABCDEF Bundle Implementation: The ICU Liberation Campaign Experience

被引：47

作者：

Balas, Michele C. ^{[1
,2
]}

Pun, Brenda T. ^{[3
]}

Pasero, Chris

Engel, Heidi J. ^{[4
]}

Perme, Christiane ^{[5
]}

Esbrook, Cheryl L. ^{[6
]}

Kelly, Tamra ^{[7
]}

Hargett, Ken D. ^{[5
]}

Posa, Patricia J. ^{[8
]}

Barr, Juliana ^{[9
,10
]}

Devlin, John W. ^{[11
,12
]}

Morse, Alexandra ^{[7
]}

Barnes-Daly, Mary Ann ^{[7
]}

Puntillo, Kathleen A. ^{[13
]}

Aldrich, J. Matthew ^{[14
,15
]}

Schweickert, William D. ^{[16
]}

Harmon, Lori ^{[17
]}

Byrum, Diane G. ^{[18
]}

Carson, Shannon S. ^{[19
]}

Ely, E. Wesley ^{[20
,21
]}

Stollings, Joanna L. ^{[22
]}

机构：

[1] Ohio State Univ, Coll Nursing, Ctr Excellence Crit & Complex Care, Columbus, OH 43210 USA

[2] Ohio State Univ, Wexner Med Ctr, Columbus, OH 43210 USA

[3] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[4] Univ Calif San Francisco, Dept Rehabil Serv, San Francisco, CA 94143 USA

[5] Houston Methodist Hosp, Houston, TX USA

[6] Univ Chicago Med, Chicago, IL USA

[7] Sutter Hlth, Sacramento, CA USA

[8] St Joseph Mercy Hlth Syst, Ann Arbor, MI USA

[9] VA Palo Alto Hlth Care Syst, Palo Alto, CA USA

[10] Stanford Univ, Sch Med, Dept Anesthesiol Perioperat & Pain Med, Stanford, CA 94305 USA

[11] Northeastern Univ, Pharm, Boston, MA 02115 USA

[12] Tufts Med Ctr, Div Pulm Crit Care & Sleep Med, Boston, MA 02111 USA

[13] Univ Calif San Francisco, Sch Nursing, Dept Physiol Nursing, San Francisco, CA 94143 USA

[14] Univ Calif San Francisco, Med Ctr, Crit Care Med, San Francisco, CA USA

[15] Univ Calif San Francisco, Med Ctr, San Francisco, CA USA

[16] Univ Penn, Perelman Sch Med, Med Clin, Philadelphia, PA 19104 USA

[17] Soc Crit Care Med, Qual, Mt Prospect, IL USA

[18] Innovat Solut Healthcare Educ LLC, Charlotte, NC USA

[19] Univ N Carolina, Sch Med, Chapel Hill, NC 27515 USA

[20] Vanderbilt Univ, Sch Med, Med, Nashville, TN 37212 USA

[21] VA Tennessee Valley Geriatr Res Educ Clin Ctr, Nashville, TN USA

[22] Vanderbilt Univ, Med Ctr, Dept Pharm Serv, Nashville, TN USA

来源：

CRITICAL CARE NURSE | 2019年 / 39卷 / 01期

基金：

美国国家卫生研究院;

关键词：

INTENSIVE-CARE-UNIT; CRITICALLY-ILL PATIENTS; MECHANICALLY VENTILATED PATIENTS; CONFUSION ASSESSMENT METHOD; ACUTE RESPIRATORY-FAILURE; QUALITY IMPROVEMENT; PAIN MANAGEMENT; DELIRIUM MONITORING/MANAGEMENT; PERFORMANCE IMPROVEMENT; BREATHING COORDINATION;

D O I：

10.4037/ccn2019927

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Although growing evidence supports the safety and effectiveness of the ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment), intensive care unit providers often struggle with how to reliably and consistently incorporate this interprofessional, evidence-based intervention into everyday clinical practice. Recently, the Society of Critical Care Medicine completed the ICU Liberation ABCDEF Bundle Improvement Collaborative, a 20-month, nationwide, multicenter quality improvement initiative that formalized dissemination and implementation strategies and tracked key performance metrics to overcome barriers to ABCDEF bundle adoption. The purpose of this article is to discuss some of the most challenging implementation issues that Collaborative teams experienced, and to provide some practical advice from leading experts on ways to overcome these barriers.

引用

页码：46 / 60

页数：15

共 94 条

[1] Agency for Healthcare Research and Quality, NON TRADITIONAL REF
[2] Sleep assessment by patients and nurses in the intensive care: An exploratory descriptive study
Aitken, Leanne M.
Elliott, Rosalind
Mitchell, Marion
Davis, Chelsea
Macfarlane, Bonnie
Ullman, Amanda
Wetzig, Krista
Datt, Ashika
McKinley, Sharon
[J]. AUSTRALIAN CRITICAL CARE, 2017, 30 (02) : 59 - 66
[3] [Anonymous], 2012, Jt Comm Perspect, V32, P11
[4] Setting Goals for Pain Management When Using a Behavioral Scale: Example With the Critical-Care Pain Observation Tool
Arbour, Caroline
Gelinas, Celine
[J]. CRITICAL CARE NURSE, 2011, 31 (06) : 66 - 68
[5] Early activity is feasible and safe in respiratory failure patients
Bailey, Polly
Thomsen, George E.
Spuhler, Vicki J.
Blair, Robert
Jewkes, James
Bezdjian, Louise
Veale, Kristy
Rodriquez, Larissa
Hopkins, Ramona O.
[J]. CRITICAL CARE MEDICINE, 2007, 35 (01) : 139 - 145
[6] Effectiveness and Safety of the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility Bundle
Balas, Michele C.
Vasilevskis, Eduard E.
Olsen, Keith M.
Schmid, Kendra K.
Shostrom, Valerie
Cohen, Marlene Z.
Peitz, Gregory
Gannon, David E.
Sisson, Joseph
Sullivan, James
Stothert, Joseph C.
Lazure, Julie
Nuss, Suzanne L.
Jawa, Randeep S.
Freihaut, Frank
Ely, E. Wesley
Burke, William J.
[J]. CRITICAL CARE MEDICINE, 2014, 42 (05) : 1024 - 1036
[7] Implementing the Awakening and Breathing Coordination, Delirium Monitoring/Management, and Early Exercise/Mobility Bundle into Everyday Care: Opportunities, Challenges, and Lessons Learned for Implementing the ICU Pain, Agitation, and Delirium Guidelines
Balas, Michele C.
Burke, William J.
Gannon, David
Cohen, Marlene Z.
Colburn, Lois
Bevil, Catherine
Franz, Doug
Olsen, Keith M.
Ely, E. Wesley
Vasilevskis, Eduard E.
[J]. CRITICAL CARE MEDICINE, 2013, 41 (09) : S116 - S127
[8] Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients
Barnes-Daly, Mary Ann
Phillips, Gary
Ely, E. Wesley
[J]. CRITICAL CARE MEDICINE, 2017, 45 (02) : 171 - 178
[9] Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit
Barr, Juliana
Fraser, Gilles L.
Puntillo, Kathleen
Ely, E. Wesley
Gelinas, Celine
Dasta, Joseph F.
Davidson, Judy E.
Devlin, John W.
Kress, John P.
Davidson, Judy E.
Devlin, John W.
Kress, John P.
Joffe, Aaron M.
Coursin, Douglas B.
Herr, Daniel L.
Tung, Avery
Robinson, Bryce R. H.
Fontaine, Dorrie K.
Ramsay, Michael A.
Riker, Richard R.
Sessler, Curtis N.
Pun, Brenda
Skrobik, Yoanna
Jaeschke, Roman
[J]. CRITICAL CARE MEDICINE, 2013, 41 (01) : 263 - 306
[10] Intensive Care Delirium Screening Checklist: evaluation of a new screening tool
Bergeron, N
Dubois, MJ
Dumont, M
Dial, S
Skrobik, Y
[J]. INTENSIVE CARE MEDICINE, 2001, 27 (05) : 859 - 864

← 1 2 3 4 5 6 7 8 9 10 →