2.50
Hdl Handle:
http://hdl.handle.net/10755/616331
Category:
Full-text
Type:
Poster
Title:
Reducing Time on the Ventilator Using the ABCDEF Bundle
Author(s):
Haynes, Annette; Lough, Mary E.; Shinn, Julie A.
Lead Author STTI Affiliation:
Alpha Eta
Author Details:
Annette Haynes, RN, CCRN, CCNS, AnHaynes@stanfordhealthcare.org; Mary E. Lough, RN, CCRN, CCNS; Julie A. Shinn, RN, CCRN, FAHA, FAAN
Abstract:
Session presented on Saturday, July 23, 2016 and Sunday, July 24, 2016: Teamwork is essential to improve patient care outcomes. This presentation will focus on a multidisciplinary initiative involving an internationally recognized bundle of interventions that reduce time on the ventilator for patients in the intensive care unit (ICU). The evidence-based bundle components target: Airway, Breathing, Coordination, Delirium, Exercise/Early mobility and Family involvement (ABCDEF). Airway strategies include a change to sub-glottic endotracheal tubes that reduce ventilator-associated pneumonia (VAP). Breathing strategies include reducing levels of sedation and scheduled spontaneous breathing trials to improve time to extubation. Coordination is by the bedside nurse so that an alert patient can pass a spontaneous breathing trial prior to extubation. Delirium prevention is a hallmark of this initiative. Patients who have less delirium have shorter lengths of stay and improved cognitive outcomes after ICU. Exercise and early mobility while on the ventilator only happen when patients are alert and delirium-free. Screening for delirium increased from 16% to 100% over a 1-year period. Family support was encouraged. Multidisciplinary team strategies for enabling change over a one-year period were planned. The team audited current practice, provided staff education for all of the ABCDEF components, achieved administrative support for purchase of new equipment and increased support from Physical Therapy to help with early mobility.' The improved outcomes were publicized to all disciplines to maintain momentum, specifically to: nurses, respiratory therapists, rehabilitation specialists, pharmacists, physicians, administrators. The team followed the principles of the Comprehensive Unit Safety Program (CUSP) to enact a permanent change in culture at the bedside. The status quo was having patients sedated and non-responsive. As a result of the ABCDEF initiative many more ventilated patients are alert, interactive and mobile. A strong motivator for this team was the realization that shorter lengths of stay in the ICU and freedom from delirium are both associated with improved patient outcomes post-ICU.
Keywords:
Delirium; Sedation; Ventilator
Repository Posting Date:
13-Jul-2016
Date of Publication:
13-Jul-2016 ; 13-Jul-2016
Other Identifiers:
INRC16PST210; INRC16PST210
Conference Date:
2016
Conference Name:
27th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Cape Town, South Africa
Description:
Theme: Leading Global Research: Advancing Practice, Advocacy, and Policy

Full metadata record

DC FieldValue Language
dc.language.isoenen
dc.type.categoryFull-texten
dc.typePosteren
dc.titleReducing Time on the Ventilator Using the ABCDEF Bundleen
dc.contributor.authorHaynes, Annetteen
dc.contributor.authorLough, Mary E.en
dc.contributor.authorShinn, Julie A.en
dc.contributor.departmentAlpha Etaen
dc.author.detailsAnnette Haynes, RN, CCRN, CCNS, AnHaynes@stanfordhealthcare.org; Mary E. Lough, RN, CCRN, CCNS; Julie A. Shinn, RN, CCRN, FAHA, FAANen
dc.identifier.urihttp://hdl.handle.net/10755/616331-
dc.description.abstractSession presented on Saturday, July 23, 2016 and Sunday, July 24, 2016: Teamwork is essential to improve patient care outcomes. This presentation will focus on a multidisciplinary initiative involving an internationally recognized bundle of interventions that reduce time on the ventilator for patients in the intensive care unit (ICU). The evidence-based bundle components target: Airway, Breathing, Coordination, Delirium, Exercise/Early mobility and Family involvement (ABCDEF). Airway strategies include a change to sub-glottic endotracheal tubes that reduce ventilator-associated pneumonia (VAP). Breathing strategies include reducing levels of sedation and scheduled spontaneous breathing trials to improve time to extubation. Coordination is by the bedside nurse so that an alert patient can pass a spontaneous breathing trial prior to extubation. Delirium prevention is a hallmark of this initiative. Patients who have less delirium have shorter lengths of stay and improved cognitive outcomes after ICU. Exercise and early mobility while on the ventilator only happen when patients are alert and delirium-free. Screening for delirium increased from 16% to 100% over a 1-year period. Family support was encouraged. Multidisciplinary team strategies for enabling change over a one-year period were planned. The team audited current practice, provided staff education for all of the ABCDEF components, achieved administrative support for purchase of new equipment and increased support from Physical Therapy to help with early mobility.' The improved outcomes were publicized to all disciplines to maintain momentum, specifically to: nurses, respiratory therapists, rehabilitation specialists, pharmacists, physicians, administrators. The team followed the principles of the Comprehensive Unit Safety Program (CUSP) to enact a permanent change in culture at the bedside. The status quo was having patients sedated and non-responsive. As a result of the ABCDEF initiative many more ventilated patients are alert, interactive and mobile. A strong motivator for this team was the realization that shorter lengths of stay in the ICU and freedom from delirium are both associated with improved patient outcomes post-ICU.en
dc.subjectDeliriumen
dc.subjectSedationen
dc.subjectVentilatoren
dc.date.available2016-07-13T11:10:06Z-
dc.date.issued2016-07-13-
dc.date.issued2016-07-13en
dc.date.accessioned2016-07-13T11:10:06Z-
dc.conference.date2016en
dc.conference.name27th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationCape Town, South Africaen
dc.descriptionTheme: Leading Global Research: Advancing Practice, Advocacy, and Policyen
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