Iwant case study about one pt with respiratory disease with overview on respiratory disease signs complication etc in brief then I need nursing care plan related to pt condition with common nursing diagnosis goal intervention evaluation in sechedule and bundle of care for same pt and path way since admission until discharge , second case on pt with heart disease same technique of respiratory
Outcomes of ABCDE Bundle in Mechanically Ventilated Patients
Increasing focus on ICU utilisation and survivorship has also resulted in a greater focus on the long-term
consequences of critical illness. Post Intensive Care Syndrome (PICS) is characterised by physical, cognitive,
and emotional manifestations and can have a long-lasting impact on survivors of ICU as well as their families
and caregivers.
The ABCDEF bundle is an organisational approach that is used to screen and treat variables that affect ICU
patients. The bundle consists of the following components:
A – Assess, prevent and manage pain;
B – Both spontaneous awakening trials and spontaneous breathing trials;
C -Choice of analgesia and sedation;
D – assess, prevent, and manage Delirium;
E- Early mobility and exercise; and
F -Family engagement and empowerment.
Over the years, the ABCDEF bundle has demonstrated improvement in duration of mechanical ventilation,
delirium, mobilisation, and survival of ICU patients. Greater compliance with the bundle is associated with
incremental improvements. The Society of Critical Care Medicine has also initiated the ICU Liberation
Collaborative, which is designed to facilitate the application of the Pain, Agitation, and Delirium Guidelines
through the ABCDEF bundle.
In this review, the authors staged partial and full implementation of the ABCDE bundle components in adult
mechanically ventilated patients. Both ICUs had already performed component B at baseline. A and D were
added to both ICUs, and E and C were added to one ICU. The full bundle was thus implemented as B-AD-ED,
and the partial bundle was B-AD. At the time this study was conducted, F was not part of the bundle. 1855
patients were included in this study.
Findings showed that the addition of E and C improved mobilisation and reduced ICU-acquired pressure ulcers
and restraint. Full implementation was also associated with greater reductions in the duration of mechanical
ventilation and hospital length of stay. In addition, full implementation reduced total hospital cost by 30.2%.
These findings confirm the positive impacts of the ABCDEF bundle. Not only does this approach improve
patient outcomes, but it also provides cost benefits. There is definitely an advantage for ICU patients and
clinicians to get from A to F.
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It is important to note that the implementation of the ABCDEF bundle is still inconsistent across ICUs. There is
a need to knock down barriers and to ensure good ideas and useful approaches are implemented so that care
delivery is improved and patient outcomes are better.
Source: Critical Care Medicine
Image Credit: iStock
Published on : Wed, 26 Jun 2019
© For personal and private use only. Reproduction must be permitted by the copyright holder. Email to copyright@mindbyte.eu.
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