Implementation of the ABCDE Bundle to Improve Patient Outcomes in the Intensive Care Unit in a Rural Community
Stacey L Kram1, Mary C DiBartolo, Katherine Hinderer
1Stacey L. Kram, DNP, RN-BC, CCRN, PCCN, is a manager at the University of Maryland Shore Regional Health, Easton. Mary C. DiBartolo, PhD, RN-BC, CNE, is a professor of Nursing, Salisbury University, Maryland. Katherine Hinderer, PhD, RN, CCRN-K, CNE, is an assistant professor of nursing, Salisbury University, Maryland. Ruth Ann Jones, EdD, MSN, RN, is the director of Acute Care and Emergency Services, University of Maryland Shore Regional Health, Easton.
Implementing the ABCDE bundle (awakening, breathing, coordination, delirium management, early mobility) in an ICU reduced hospital stays and mechanical ventilation duration. This evidence-based approach is safe and cost-effective for rural hospitals.
Area of Science:
- Critical Care Medicine
- Evidence-Based Practice
- Patient Outcomes
Background:
- The ABCDE bundle is a multidisciplinary approach to improve outcomes in adult intensive care units (ICUs).
- It aims to mitigate negative effects of prolonged hospitalization, such as delirium, through coordinated care.
- Previous implementations show reduced ICU/hospital length of stay, shorter mechanical ventilation, and decreased delirium prevalence.
Purpose of the Study:
- To implement the ABCDE bundle in a general adult ICU at a rural community hospital.
- To evaluate the bundle's impact on patient outcomes in a community-based setting.
Main Methods:
- An evidence-based practice project focused on implementing the ABCDE bundle in a six-bed adult ICU.
- Data collected over a 3-month period to assess changes in patient outcomes.
Main Results:
- Average patient hospital length of stay decreased by 1.8 days.
- Average length of mechanical ventilation was reduced by 1 day.
- A baseline delirium prevalence of 19% was established.
Conclusions:
- The ABCDE bundle is feasible for implementation in rural, community-based hospitals.
- The bundle offers a safe and cost-effective strategy for improving ICU patient outcomes.
- Findings support the broader adoption of the ABCDE bundle in diverse healthcare settings.
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