ArticleAmerican journal of critical care : an official publication, American Association of Critical-Care Nurses2022
Effects of a National Quality Improvement Collaborative on ABCDEF Bundle Implementation.
Article in American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
What it found
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Who cites it
10 citing papers in PubMed.
- Article
- Article
- Interprofessional Simulation-Based Training to Facilitate ABCDEF Bundle Implementation.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2025Article
- Implementation of a Quality Improvement Tool "Recover25" to Guide the Care of Patients Experiencing Prolonged Critical Illness: A Mixed-Method Feasibility Study.Critical care explorations · 2025Article
- Patient, Practice, and Organizational Factors Associated With Early Mobility Performance in Critically Ill Adults.American journal of critical care : an official publication, American Association of Critical-Care Nurses · 2024Article
- Shift-Level Team Familiarity Is Associated with Improved Outcomes in Mechanically Ventilated Adults.American journal of respiratory and critical care medicine · 2024Article
- Social Determinants of Health and Delivery of Rehabilitation to Older Adults During ICU Hospitalization.JAMA network open · 2024Article
- Patterns of interactions among ICU interprofessional teams: A prospective patient-shift-level survey approach.PloS one · 2024Article
- Article
- Decline in Prolonged Acute Mechanical Ventilation, 2011-2019.American journal of respiratory and critical care medicine · 2022Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe ABCDEF bundle (Assess, prevent, and manage pain and Delirium; Both spontaneous awakening and breathing trials; Choice of analgesia/sedation; Early mobility; and Family engagement) improves intensive care unit outcomes, but adoption into practice is poor.
objectiveTo assess the effect of quality improvement collaborative participation on ABCDEF bundle performance.
methodsThis interrupted time series analysis included 20 months of bundle performance data from 15 226 adults admitted to 68 US intensive care units. Segmented regression models were used to quantify complete and individual bundle element performance changes over time and compare performance patterns before (6 months) and after (14 months) collaborative initiation.
resultsComplete bundle performance rates were very low at baseline (<4%) but increased to 12% by the end. Complete bundle performance increased by 2 percentage points (SE, 0.9; P = .06) immediately after collaborative initiation. Each subsequent month was associated with an increase of 0.6 percentage points (SE, 0.2; P = .04). Performance rates increased significantly immediately after initiation for pain assessment (7.6% [SE, 2.0%], P = .002), sedation assessment (9.1% [SE, 3.7%], P = .02), and family engagement (7.8% [SE, 3%], P = .02) and then increased monthly at the same speed as the trend in the baseline period. Performance rates were lowest for spontaneous awakening/breathing trials and early mobility.
conclusionsQuality improvement collaborative participation resulted in clinically meaningful, but small and variable, improvements in bundle performance. Opportunities remain to improve adoption of sedation, mechanical ventilation, and early mobility practices.
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