Bardwell Jennifer, Brimmer Sushama, Davis Wesley
Jennifer Bardwell is Nurse Practitioner, CHRISTUS Good Shepherd Medical Center and Taylor Medical Center Urgent Care, Longview, Texas.
Sushama Brimmer is Chief Hospitalist and Medical Director, CHRISTUS Good Shepherd Medical Center, Longview, Texas.
AACN Adv Crit Care. 2020 Mar 15;31(1):16-21. doi: 10.4037/aacnacc2020451.
Prolonged mechanical ventilation of patients in intensive care units across the United States consumes billions of health care dollars every year. Using the awakening and breathing coordination, delirium monitoring/management, and early mobility (ABCDE) bundle along with the Critical-Care Pain Observation Tool and the Richmond Agitation-Sedation Scale combines the best available evidence to optimize outcomes for critically ill patients. This study is the first to examine the effects of implementing the ABCDE bundle, the Critical-Care Pain Observation Tool, and the Richmond Agitation-Sedation Scale together in a coordinated effort across multiple disciplines. The aim of using this combination of evidence-based tools is to reduce ventilation time by reducing oversedation, decreasing the incidence of delirium, and improving pain management.
在美国,重症监护病房患者的长期机械通气每年耗费数十亿美元的医疗保健费用。采用觉醒与呼吸协调、谵妄监测/管理及早期活动(ABCDE)集束化方案,同时结合重症监护疼痛观察工具和里士满躁动-镇静量表,整合了现有最佳证据,以优化重症患者的治疗效果。本研究首次探讨了跨多学科协同实施ABCDE集束化方案、重症监护疼痛观察工具和里士满躁动-镇静量表的效果。使用这些循证工具组合的目的是通过减少过度镇静、降低谵妄发生率及改善疼痛管理来缩短通气时间。