Implementation Plan for the ABCDEF Bundle

Abstract

Intensive care delirium prevention is currently a practice improvement goal of the Society of Critical Care Medicine. Delirium increases morbidity, mortality, time mechanically ventilated, length of stay, and health care spending. The Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit (PAD guidelines) were revised and published in 2013. The ICU Delirium and Cognitive Impairment Study Group at Vanderbilt University have developed the ABCDEF Bundle protocol as a way of operationalizing the 2013 PAD guidelines. Implementation of the ABCDEF Bundle protocol has been shown to decrease occurrence and duration of delirium while improving morbidity and mortality therefore decreasing length of stay. The purpose of this project is to develop an implementation and evaluation plan of the ABCDEF Bundle for a community hospital's TSICU in Arizona. The Squire guidelines for quality improvement reporting are followed for this project. Implementation and evaluation of the ABCDEF bundle are explained in detail.