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ICU team composition and its association with ABCDE implementation in a quality collaborative.

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Interprofessional team involvement, particularly nurses and physicians, is crucial for the successful implementation of the Awakening, Breathing Coordination, Delirium, and Early Mobility (ABCDE) bundle in ICUs.

Keywords:
Implementation sciencePatient care teamPatient safetyQuality improvementVentilator weaning

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Area of Science:

  • Critical Care Medicine
  • Healthcare Management
  • Patient Safety

Background:

  • The Awakening, Breathing Coordination, Delirium, and Early Mobility (ABCDE) bundle is vital for intensive care unit (ICU) patient outcomes.
  • Successful ABCDE implementation relies on interprofessional teams, but optimal team composition remains unclear.

Purpose of the Study:

  • To investigate the relationship between interprofessional team composition and the implementation of the ABCDE bundle in ICUs.
  • To identify specific healthcare professional roles associated with routine ABCDE bundle adoption.

Main Methods:

  • A survey was administered to participants at an ICU workshop, assessing team involvement in spontaneous awakening trials (SATs), spontaneous breathing trials, delirium management, and early mobility.
  • Ordinal logistic regression was used to analyze the association between team composition and ABCDE implementation levels.

Main Results:

  • Frequent involvement of nurses and physicians in SATs was linked to higher ABCDE implementation.
  • Nurse and nursing assistant participation in delirium management and early mobility interventions showed significant associations with routine ABCDE care.
  • Physician and nursing assistant involvement in early mobility also correlated with increased ABCDE implementation.

Conclusions:

  • The study highlights that robust ABCDE bundle implementation is associated with the frequent engagement of various interprofessional team members.
  • Findings underscore the necessity for clear role definition and enhanced coordination among ICU team members for effective ABCDE bundle delivery.