THE IMPACT OF ABCDE BUNDLE IMPLEMENTATION ON MECHANICALLY VENTILATED PATIENTS OUTCOMES AT ICU IN HEBRON GOVERNMENTAL HOSPITAL
No Thumbnail Available
Date
2024-10-15
Authors
Sawsan, Al-Sarahinah
Journal Title
Journal ISSN
Volume Title
Publisher
An-Najah National University
Abstract
Background: ABCDE bundle implementation is an evidence based and recommended practice to adequately manage mechanically ventilated patients, but application of this bundle in environment with shortage of resources and has no specific protocol to deal with mechanically ventilated patients is unknown
Objective: to measure the impact of ABCDE bundle implementation on mechanically ventilated patients' outcomes: ICU length of stay, ventilator free days, delirium occurrence and duration, and early mobility at ICU in Hebron Governmental Hospital.
Methods: a prospective-quasi experimental study was conducted between December-2022 to March-2024, in which 76 patients on mechanical ventilation were divided into two groups. In the pre ABCDE bundle (n=36), traditional approach to deal with mechanically ventilated patients was used. In the post ABCDE bundle group (n=40), ABCDE bundle was used. Those outcomes were compared between both groups: ICU LOS, VFDs, delirium occurrence and duration, and early mobility.
Results: the results showed no statistically significant differences between two groups regarding ICU LOS, VFDs (P=0.88, P=0.9) respectively. The median duration of MV was less in the intervention group 3 days in comparison to 3.5 days in control group (P=0.378). The percentage of early mobility was higher in ABCDE group (P=0.242). ABCDE group was more lightly sedated than non-ABCDE group who was more deeply sedated. Delirium occurrence and duration were less in ABCDE group (P= 0.362, P=0.22) respectively. Restraints use was significantly decreased in group who adapted bundle (20.5% in intervention group versus 44.4% in control group) with P value=0.008.
Conclusion: ABCDE bundle helped in making mechanically ventilated patients more awake and oriented to environment and decreased using of restrains among them. It also minimized the use of benzodiazepines to half. Other outcomes like ICU LOS, VFDs, delirium occurrence and duration, and early mobility needs more research with larger sample size and more effective adherence to bundle. This study gave background for the future research to implement this bundle in environment with shortage of resources.
Keywords: ABCDE bundle, ICU LOS, mechanical ventilation, delirium, early mobility.