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ABCDEF 包在管理和预防谵妄中的有效性:干预前后准实验研究。

Effectiveness of the ABCDEF Bundle to Manage and Prevent Delirium: Pre- and Postintervention Quasi-Experimental Study.

机构信息

Author Affiliations: Critical Care and Emergency Nursing Department, Faculty of Nursing, South Valley University, Qena (Nagy Nagm Eldean); Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, Egypt (Hassan Bakri); Critical Care and Emergency Nursing, Faculty of Nursing, Assiut University, Assiut, Egypt (Anwar Abdel Aziz and Khalaf).

出版信息

Crit Care Nurs Q. 2024;47(4):275-285. doi: 10.1097/CNQ.0000000000000519. Epub 2024 Sep 13.

Abstract

UNLABELLED

To investigate effectiveness of the ABCDEF bundle to manage and prevent delirium.

BACKGROUND

ICU delirium is a common hospital problem that 80% of critically ill patients in the ICU experience. The ABCDEF bundle is one of the tools that included in Delirium guidelines to manage critically ill patients.

RESEARCH DESIGN

Pre- and post intervention a quasi-experimental design was utilized in the present study.

SETTING

This study was conducted in the intensive care units of Assiut University Hospital.

METHODS

A total of 60 mechanically ventilated patients were recruited using inclusion and exclusion criteria. The ABCDEF bundle was implemented every day for the first 7 days of ICU admission, and patient sedation and delirium status were assessed using the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU). Sedation instrument measures were utilized in data collection.

RESULTS

Significant differences were found in the incidence of delirium: 20% in the study group versus 70% in the control group. The increased mean of days without delirium ICU stay was 4.6333 in the study group and 1.1000 in the control group, with P value = .001.

CONCLUSION

The mechanically ventilated patients exposed to the implementation of the ABCDE bundle experienced fewer delirium signs than before the ABCDE bundle was implemented.

摘要

目的

研究 ABCDEF 方案在管理和预防谵妄方面的效果。

背景

ICU 谵妄是 ICU 中 80%的危重症患者常见的医院问题。ABCDEF 方案是管理危重症患者的谵妄指南中包含的工具之一。

研究设计

本研究采用了预-后干预的准实验设计。

设置

这项研究在艾斯尤特大学医院的重症监护病房进行。

方法

采用纳入和排除标准,共招募了 60 名机械通气患者。在 ICU 入院的前 7 天,每天实施 ABCDEF 方案,使用 ICU 意识模糊评估法(CAM-ICU)评估患者的镇静和谵妄状态。使用镇静仪器测量来收集数据。

结果

在谵妄发生率方面发现了显著差异:研究组为 20%,对照组为 70%。研究组 ICU 无谵妄停留天数的平均增加了 4.6333 天,对照组为 1.1000 天,P 值=0.001。

结论

与 ABCDEF 方案实施前相比,接受 ABCDE 方案实施的机械通气患者出现谵妄迹象的情况更少。

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