Critical care nurses’ practices in implementing the “ABCDE bundle” among mechanically ventilated patients

Abstract

One of the principal complications in patients in the intensive care unit (ICU), particularly in those receiving mechanical ventilation (MV), is delirium, which is a disturbance of consciousness, attention, cognition and perception that develops over a short period of time usually hours to days and tends to fluctuate during the course of the day .It is associated with increased mortality, prolonged mechanical ventilation, and prolonged hospital length of stay (LOS). The ABCDE is stand for Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility bundle that has been proposed as an interdisciplinary, multi-component intervention in ICUs to reduce incidence of delirium. Aim of study: this study aims to evaluate the effect of implementing the ABCDE bundle on reduction of delirium among mechanically ventilated patients at Damietta hospital. Methods: A quasi experimental research pre/post intervention design will be used to conduct this study to demonstrate causality between an intervention and an outcome. The study was carried out at ICU of Damietta Chest Disease Hospital. A purposive sample of 65 adult mechanically ventilated critically patients aged between 18 and 60 of both sexes will be included. Sedation and Delirium assessment tools are used. Result: This study shows that mechanically ventilated patients who exposed to implementation of ABCDE bundle were experienced less delirium signs than prior to ABCDE bundle implementation (usual care). So; there were significant differences in delirium scores among the studied patients before and after intervention with x2=52.52 and p-value=0.001*