Effect of ABCDE Bundle Implementation on Prevalence of Delirium in Intensive Care Unit Patients.
The ABCDE bundle incorporates multidisciplinary measures to improve and/or preserve patients' physical, functional, and neurocognitive status through awakening and breathing coordination, delirium prevention and management, and early physical mobility.



To quantify the prevalence and duration of delirium in patients in the intensive care unit (ICU) before and after implementation of the ABCDE bundle.



Delirium prevalence was defined as the percentage of patients who had at least 1 positive delirium score on the Intensive Care Delirium Screening Checklist (ICDSC) during the ICU stay; delirium duration was the number of days during the ICU stay that a positive ICDSC score was noted. Retrospective data were collected from before and after implementation of the ABCDE bundle.



Of the 159 records reviewed (80 before and 79 after bundle implementation), most were for white men (mean age, 66.3 years). After implementation of the ABCDE bundle, the prevalence of delirium decreased significantly (from 38% to 23%, P = .01) and the mean number of days of delirium decreased significantly (from 3.8 to 1.72 days, P < .001). The number of patients with delirium-free stays increased after bundle implementation.



Implementation of the ABCDE bundle led to significant decreases in the prevalence and duration of delirium in ICU patients.
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health. mbounds@umm.edu.
Mandy
M
Bounds
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health.
Stacey
S
Kram
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health.
Karen Gabel
KG
Speroni
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health.
Kim
K
Brice
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health.
Mary Anne
MA
Luschinski
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health.
Stephanie
S
Harte
Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health.
Marlon G
MG
Daniel
D000368:Aged; D003422:Critical Care / Q000379:methods*; D003693:Delirium / Q000453:epidemiology* / Q000517:prevention & control*; D004434:Early Ambulation / Q000379:methods; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008396:Maryland / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies; D015300:Ventilator Weaning / Q000379:methods