实施ABCDEF集束化治疗：ICU解放ABCDEF集束化治疗改进协作期间提出的8大常见问题

Implementing the ABCDEF Bundle: Top 8 Questions Asked During the ICU Liberation ABCDEF Bundle Improvement Collaborative.

作者信息

Stollings Joanna L, Devlin John W, Pun Brenda T, Puntillo Kathleen A, Kelly Tamra, Hargett Ken D, Morse Alexandra, Esbrook Cheryl L, Engel Heidi J, Perme Christiane, Barnes-Daly Mary Ann, Posa Patricia J, Aldrich J Matthew, Barr Juliana, Carson Shannon S, Schweickert William D, Byrum Diane G, Harmon Lori, Ely E Wesley, Balas Michele C

机构信息

Joanna Stollings is a clinical pharmacist, Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee.

John Devlin is Professor of Pharmacy, Northeastern University, and a clinical scientist, Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, Massachusetts.

出版信息

Crit Care Nurse. 2019 Feb;39(1):36-45. doi: 10.4037/ccn2019981.

DOI:10.4037/ccn2019981

PMID:30710035

Abstract

The ABCDEF bundle (A, assess, prevent, and manage pain; B, both spontaneous awakening and spontaneous breathing trials; C, choice of analgesic and sedation; D, delirium: assess, prevent, and manage; E, early mobility and exercise; and F, family engagement and empowerment) improves intensive care unit patient-centered outcomes and promotes interprofessional teamwork and collaboration. The Society of Critical Care Medicine recently completed the ICU Liberation ABCDEF Bundle Improvement Collaborative, a 20-month, multicenter, national quality improvement initiative that formalized dissemination and implementation strategies to promote effective adoption of the ABCDEF bundle. The purpose of this article is to describe 8 of the most frequently asked questions during the Collaborative and to provide practical advice from leading experts to other institutions implementing the ABCDEF bundle.

摘要

ABCDEF集束化护理（A，评估、预防和处理疼痛；B，自主唤醒和自主呼吸试验；C，镇痛和镇静的选择；D，谵妄：评估、预防和处理；E，早期活动与锻炼；F，家属参与和赋权）可改善重症监护病房以患者为中心的结局，并促进跨专业团队合作。危重病医学会最近完成了ICU解放ABCDEF集束化护理改进协作项目，这是一项为期20个月的多中心全国质量改进计划，该计划将传播和实施策略正式化，以促进ABCDEF集束化护理的有效采用。本文旨在描述协作过程中最常被问到的8个问题，并提供来自顶尖专家的实用建议，以供其他实施ABCDEF集束化护理的机构参考。