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Effects of the ABCDE bundle on the prevention of post-intensive care syndrome: A retrospective study

YoonMi Lee1, Kyunghee Kim2, Changwon Lim3

  • 1Department of Nursing, Samgsung Medical Center, Seoul, Republic of Korea.

Journal of Advanced Nursing
|November 16, 2019
PubMed

Insights

The modified ABCDE bundle significantly reduced deep sedation and immobilization in intensive care patients, preventing post-intensive care syndrome (PICS). Institutions should develop tailored protocols for effective ABCDE bundle implementation.

Area of Science:

  • Critical Care Medicine
  • Intensive Care Unit (ICU) Management
  • Patient Recovery and Outcomes

Background:

  • Post-intensive care syndrome (PICS) is a significant concern for ICU survivors, often linked to deep sedation and immobility.
  • The ABCDE bundle is a framework designed to improve patient care in the ICU.
  • Evaluating the impact of different versions of the ABCDE bundle is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To assess the specific effects of the early and modified ABCDE bundles on preventing PICS.
  • To determine how each component of the ABCDE bundle contributes to patient recovery.
  • To identify improvements in sedation and mobility associated with the modified bundle.

Main Methods:

  • Retrospective analysis of electronic medical records from 185 ICU patients.
  • Comparison of patients receiving the early ABCDE bundle (2013) versus a modified bundle (2014).
  • Analysis focused on sedation levels (alertness/calmness, coma) and early mobility interventions.

Main Results:

  • The modified ABCDE bundle significantly increased the percentage of patients achieving alertness and calmness (58.2% to 72.4%).
  • Coma prevalence decreased significantly with the modified bundle (45.1% to 28.7%).
  • Early mobility interventions increased substantially, from 11% with the early bundle to 54.3% with the modified bundle.

Conclusions:

  • The ABCDE bundle effectively prevents PICS by mitigating deep sedation and immobility in ICU patients.
  • Implementation requires institutions to develop specific protocols for each element of the bundle.
  • The ABCDE bundle serves as a valuable tool for evidence-based practice in critical care, aiding PICS prevention.
Abstract

Keywords:
ABCDE bundleevidence-based practiceintensive care unitnursenursingpost-intensive care syndrome

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