SCCM Resource Library-Introduction to the Bundle

Pdf Summary

The book "Introduction to the Bundle" focuses on practical application strategies for the ICU Liberation Bundle, developed to address the challenges of implementing the Society of Critical Care Medicine's (SCCM) PAD (Pain, Agitation, Delirium) and PADIS (Pain, Agitation, Sedation, Delirium, Immobility, Sleep Disruption) guidelines. Authored by Patricia Posa, Jaspal Singh, and Joanna Stollings, it offers comprehensive insights into bridging the gap between these guidelines and practical ICU care.<br /><br />The ICU Liberation Bundle, formerly known as ABCDEF, encapsulates six core components: Assessment and management of pain (A), spontaneous awakening and breathing trials (B), Choice of sedation and analgesia (C), Delirium management (D), Early mobility (E), and Family engagement (F). Research involving over 20,000 patients has shown that adherence to this bundle significantly reduces ICU and hospital days, mechanical ventilation needs, delirium incidence, and healthcare costs, among other benefits.<br /><br />Despite the benefits, global implementation in ICUs remains inadequate. This book aims to equip frontline healthcare teams with the tools needed for effective implementation. It combines science and practical recommendations, providing real-world strategies for overcoming common barriers to adoption. Each chapter discusses challenges and solutions related to adopting these guidelines and highlights the importance of interprofessional teamwork, performance improvements, and data utilization to foster an effective care culture.<br /><br />Moreover, the book includes updates on the role of sleep in patient recovery, managerial insights into ICU team dynamics, discussion on post-intensive care syndrome (PICS), and specific guidance for pediatric care. It encourages readers to participate in simulation training courses designed to complement the book’s teachings and hopes to inspire healthcare teams to enhance care for ICU patients.

Asset Subtitle

Quality and Patient Safety, Pharmacology, 2020, 00:20:00

Asset Caption

This is a complimentary chapter from the textbook, ICU Liberation, Second Edition ), titled "Introduction to the Bundle." The Society of Critical Care Medicine (SCCM) has endorsed and published the 2013 Pain, Agitation, and Delirium (PAD) guidelines and the 2018 Pain, Agitation, Sedation, Delirium, Immobility, and Sleep Disruption (PADIS) guidelines, which outline the best evidence available for addressing pain, agitation, delirium, early mobility, and sleep. Many ICUs have found adoption of the PAD and PADIS guidelines difficult in practice, either as individual components or when integrated with other aspects of patient care. Because of the difficulties found with implementation of the guidelines, an evidence-based, bundled approach was developed to aid in the clinical application of the PAD and PADIS guidelines, called the ICU Liberation Bundle. This bundle was formerly referred to as ABCDEF, a mnemonic representing the key bundle elements: A for Assessment, prevention, and management of pain; B for Both spontaneous awakening trials and spontaneous breathing trials; C for Choice of sedation and analgesia; D for Delirium assessment, prevention, and management; E for Early mobility and exercise; and F for Family engagement and empowerment. The ICU Liberation Bundle has been studied in more than 20,000 patients, demonstrating a reduction in ICU days, hospital days, next-day mechanical ventilation, coma, delirium, hospital mortality, use of physical restraints, ICU readmissions, transfer to a facility, and healthcare costs. Despite several studies demonstrating the benefit of compliance with the ICU Liberation Bundle, global implementation within the ICU has not yet been established.

Meta Tag

Content Type Book Chapter

Knowledge Area Quality and Patient Safety

Knowledge Area Pharmacology

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Guidelines

Tag Analgesia and Sedation

Year 2020

Keywords

ICU Liberation Bundle

PAD guidelines

PADIS guidelines

critical care

pain management

sedation

delirium

early mobility

healthcare implementation

patient recovery

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