دورية أكاديمية
أعرض في EDS

ABCDE and ABCDEF care bundles: A systematic review of the implementation process in intensive care units.

التفاصيل البيبلوغرافية
العنوان: ABCDE and ABCDEF care bundles: A systematic review of the implementation process in intensive care units.
المؤلفون: Moraes FDS; Graduate Program in Pharmaceutical Sciences, University of Sorocaba, Sorocaba, São Paulo, Brazil., Marengo LL, Moura MDG, Bergamaschi CC, de Sá Del Fiol F, Lopes LC, Silva MT, Barberato-Filho S
المصدر: Medicine [Medicine (Baltimore)] 2022 Jun 24; Vol. 101 (25), pp. e29499. Date of Electronic Publication: 2022 Jun 24.
نوع المنشور: Journal Article; Meta-Analysis; Systematic Review
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 2985248R Publication Model: Electronic Cited Medium: Internet ISSN: 1536-5964 (Electronic) Linking ISSN: 00257974 NLM ISO Abbreviation: Medicine (Baltimore) Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hagerstown, Md : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Delirium*/prevention & control , Patient Care Bundles*, Critical Care/methods ; Critical Illness ; Humans ; Intensive Care Units
مستخلص: Background: The ABCDE (Awakening and Breathing Coordination of daily sedation and ventilator removal trials, Delirium monitoring and management, and Early mobility and exercise) and ABCDEF (Assessment, prevent and manage pain, Both spontaneous awakening and spontaneous breathing trials, Choice of analgesia and sedation, assess, prevent and manage Delirium, Early mobility and exercise, Family engagement) care bundles consist of small sets of evidence-based interventions and are part of the science behind Intensive Care Unit (ICU) liberation. This review sought to analyse the process of implementation of ABCDE and ABCDEF care bundles in ICUs, identifying barriers, facilitators and changes in perception and attitudes of healthcare professionals; and to estimate care bundle effectiveness and safety.
Methods: We selected qualitative and quantitative studies addressing the implementation of ABCDE and ABCDEF bundles in the ICU, identified on MEDLINE, Embase, CINAHL, The Cochrane Library, Web of Science, Epistemonikos, PsycINFO, Virtual Health Library and Open Grey, without restriction on language or date of publication, up to June 2018. The outcomes measured were ICU and hospital length of stay; mechanical ventilation time; incidence and prevalence of delirium or coma; level of agitation and sedation; early mobilization; mortality in ICU and hospital; change in perception, attitude or behaviour of the stakeholders; and change in knowledge of health professionals. Two reviewers independently selected the studies, performed data extraction, and assessed risk of bias and methodological quality. A meta-analysis of random effects was performed.
Results: Twenty studies were included, 13 of which had a predominantly qualitative and 7 a quantitative design (31,604 participants). The implementation strategies were categorized according to the taxonomy developed by the Cochrane Effective Practice and Organization of Care Group and eighty strategies were identified. The meta-analysis results showed that implementation of the bundles may reduce length of ICU stay, mechanical ventilation time, delirium, ICU and hospital mortality, and promoted early mobilization in critically-ill patients.
Conclusions: : This study can contribute to the planning and execution of the implementation process of ABCDE and ABCDEF care bundles in ICUs. However, the effectiveness and safety of these bundles need to be corroborated by further studies with greater methodological rigor.
Protocol Registration: PROSPERO CRD42019121307.
Competing Interests: The authors have no conflicts of interest to disclose.
(Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.)
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تواريخ الأحداث: Date Created: 20220627 Date Completed: 20220628 Latest Revision: 20221103
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC9276239
DOI: 10.1097/MD.0000000000029499
PMID: 35758388
قاعدة البيانات: MEDLINE
الوصف
تدمد:1536-5964
DOI:10.1097/MD.0000000000029499