Best Practices for Conducting Interprofessional Team Rounds to Facilitate Performance of the ICU Liberation (ABCDEF) Bundle

Stollings, Joanna L.; Devlin, John W.; Lin, John C.; Byrum, Diane; Barr, Juliana

doi:10.1097/ccm.0000000000004197

Cited by 52 publications

(52 citation statements)

References 66 publications

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“…Conducting rounds at the bedside has been shown to improve communication and trust between the patient/family and multidisciplinary team and enhance shared understanding and shared decision making regarding the patient plan of care. [4][5][6] In addition, multidisciplinary rounds can effectively identify safety risks and prevent gaps and delays in care through the incorporation of care bundles, daily goals, and safety/quality measure checklists. 6,7 Fig.…”

Section: Discussionmentioning

confidence: 99%

Bedside Rounds in Intensive Care Units during the COVID-19 Pandemic and Beyond

Custer

Simone

Bhutta

2020

J Pediatr Intensive Care

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A survey-based pilot study was performed to examine the feasibility of videoconferencing to facilitate multidisciplinary rounds following the initiation of strict isolation and social distancing policies in a pediatric intensive care unit (PICU). The use of a mobile workstation was implemented as the central hub for rounding at the bedside by the attending physicians, while other members of the multidisciplinary and multispecialty team joined rounds from other locations with maintaining appropriate social distance. Fifty-eight staff members who participated in videoconferencing rounds completed the postimplementation survey. Eighty-eight percent of staff agreed that the use of videoconferencing to facilitate rounds was an effective strategy to maintain social distancing between team members during the pandemic. Sixty-four percent of staff agreed that the use of videoconferencing improved participation of the PICU team and consultants by increasing access to rounds. Over 50% of staff agreed that the use of videoconferencing improved the efficiency of rounds and team productivity. Only 4% of staff responded that videoconferencing increased the duration of rounds and 37% responded that it decreased resident and team education. Fifty-five percent of staff agreed that videoconferencing was used to promote parental participation during this pandemic month. Videoconferencing was found to be a feasible solution to safely conduct multidisciplinary rounds while maintaining social distancing, and participants found it effective without interfering with normal workflow. Incorporating videoconferencing into traditional rounding practices may be advantageous following the pandemic to improve team and family access to rounds and workflow efficiency and rounding structure.

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Section: Discussionmentioning

confidence: 99%

Bedside Rounds in Intensive Care Units during the COVID-19 Pandemic and Beyond

Custer

Simone

Bhutta

2020

J Pediatr Intensive Care

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“…The ABCDEF bundle is a strong evidence-based approach to ICU care that prevents ICU patients from developing physical, cognitive, and mental disabilities, termed the post-intensive care syndrome (PICS) [29], which has long lasting effects even after intensive care and hospital discharge. Many studies have suggested that each element of the bundle has its own role to prevent PICS [1,5,6,8] and synchronized implementation would provide further bene ts [30]. Despite ongoing research about the speci c outcomes of patients who survive COVID-19 infections (NCT04360538, NCT04508712), it is likely that these patients have problems similar to survivors of other critical illnesses.…”

Section: Discussionmentioning

confidence: 99%

“…The introduction of protocols, especially for pain and sedation management, could provide an ICU with a systematic and resource-conserving approach that would facilitate delivery of evidence-based ICU care [5,8,11]. However, these results show that a protocol for mobilization did not facilitate implementation of element E possibly because of the several complicated mechanisms of lung injury and different ventilation strategy in the various phases of the illness [33][34][35][36].…”

Section: Discussionmentioning

confidence: 99%

“…The implementation of ICU care, along with the ABCDEF bundle [1], PADIS guideline [2], and nutrition guidelines [3,4], have been shown to be key elements for patients in ICUs not only to improve mortality and morbidity [5] but also to rehabilitate their functional abilities and health related quality of life [6]. A variety of guidelines recommend incorporation of these evidence-based approaches to ICU care into clinical practice [1][2][3], according to the local situation and available resources [7,8].…”

Section: Introductionmentioning

confidence: 99%

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ABCDEF Bundle and Supportive ICU Care Practices for patients with COVID-19 infection: An international point prevalence study ~The ISIIC Study~

Liu

Nakamura²,

Katsukawa³

et al. 2020

Preprint

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BackgroundAlthough the number of patients with COVID-19 infection is increasing and concerns for their long-term disabilities are increasing, there is a lack of data about the delivery of the ABCDEF-bundle and supportive care in Intensive Care Units (ICUs). The aim of this study is to investigate the implementation of the ABCDEF-bundle and supportive care provided to patients with COVID-19 infections in ICUs. MethodsThis was a world-wide two-day point prevalence study, on June 3 and July 1, 2020. A total of 212 ICUs in 38 countries (166 ICUs on Day 1 and 212 on Day 2) participated. Clinicians in each participating ICU completed web-based online surveys. The implementation rate for elements of the ABCDEF-bundle, other supportive ICU care measures and implementation associated structures were investigated.RESULTSData for 262 patients was collected during the two-day study. Of patients included, 124 (47.3%) underwent mechanical ventilation (MV) and 12 (4.6%) patients were treated with extracorporeal membrane oxygenation (ECMO). The proportion of patients with implementation of each element was: Element A (regular pain assessment) 45%; B (both spontaneous awakening and breathing trials) 28%; C (regular sedation assessment) 52%; D (regular delirium assessment) 38%; E (early mobility and exercise) 47%; and F (family engagement and empowerment) 16%. The implementation of element E for patients on MV was 16% and ECMO was 17%. Supportive care, such as providing protein throughout the ICU stay (under 1.2g/kg for more than 50% of the patients) and introduction of an ICU diary (25%) was inadequate. A higher implementation rate of elements A and D were recognized in ICUs with specific protocols for ICU care and lower numbers of ICU beds exclusively for patients with COVID-19 infection. Element E was implemented at a higher rate in ICUs with more ICU beds for patients with COVID-19 infection.CONCLUSIONSThis worldwide two-day point prevalence study found low implementation of the ABCDEF-bundle. Specific protocols and the number of ICU beds reserved for patients with COVID-19 infections might be key factors to deliver appropriate supportive care.Trial registration: UMIN, UMIN000040405. Registered 14 May 2020, https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000046103

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“…Exercise and early mobilization are part of the Society of Critical Care Medicine Bundle, which aims to improve the quality of care provided to critically ill patients 90 .…”

Section: Recommendationmentioning

confidence: 99%

Evidence-based Physiotherapy and Functionality in Adult and Pediatric patients with COVID-19

Silva

Andrade

Nepomuceno³

et al. 2021

jhgd

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Introduction: The new corona virus (2019-nCoV OR HCOV-19 or CoV2), has emerged in China as the main cause of viral pneumonia (COVID-19, Coronavirus Disease-19). Objective: To provide evidence-based Physiotherapy and functionality in patients with adult and pediatric COVID-19. Methods: This is an integrative literature review using the MedLine / PubMed databases, library of Latin American and Caribbean Literature in Health Sciences (LILACS) and Physiotherapy Evidence Database (PEDRo). Results: Part of the patients with covid 19 show signs of respiratory deficiency with hypoxemia, with low severity in children. Impaired functionality is also expected. Conclusion: COVID-19 causes low pulmonary compliance and important changes in lung function with hypoxemia and cardiovascular repercussions. These changes lead to the need for Physiotherapy and the management of oxygen therapy and ventilatory support (invasive and non-invasive) for these patients.

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Best Practices for Conducting Interprofessional Team Rounds to Facilitate Performance of the ICU Liberation (ABCDEF) Bundle

Cited by 52 publications

References 66 publications

Bedside Rounds in Intensive Care Units during the COVID-19 Pandemic and Beyond

Bedside Rounds in Intensive Care Units during the COVID-19 Pandemic and Beyond

ABCDEF Bundle and Supportive ICU Care Practices for patients with COVID-19 infection: An international point prevalence study ~The ISIIC Study~

Evidence-based Physiotherapy and Functionality in Adult and Pediatric patients with COVID-19

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