Felipe Muñoz-Muñoz, Jaime Leppe, Felipe González-Seguel, Ana Castro-Ávila
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Daily bundle compliance was determined by considering the daily records for each element: Assess pain (element A), both spontaneous awakening trials (element B1) and spontaneous breathing trials (element B2), choice of sedation (element C), delirium assessment (element D), early mobilization (element E), and family engagement (element F).</p><p><strong>Results: </strong>4165 registered bundle elements were obtained from nursing (47%), physiotherapy (44%), and physicians (7%), including 1134 patient/days (from 133 patients). Elements E and C showed 67 and 40% compliance, while D, A, and B2 showed 24, 14 and 11%, respectively. For B1 and F, 0% compliance was achieved. Compliance was higher in patients without mechanical ventilation for A and E, while it was similar for D.</p><p><strong>Conclusions: </strong>Early mobilization had the highest compliance, while spontaneous awakening trials and family engagement had absolute non-compliance. 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引用次数: 0
摘要
介绍：实施 ABCDEF 套件已证明可改善危重症患者的治疗效果。本研究旨在描述智利一家重症监护病房对 ABCDEF 套件的日常遵守情况：方法：对护理 18 岁以上、入住重症监护病房至少 24 小时、使用或不使用机械通气的患者的护理、物理治疗和医疗专业人员的电子临床记录进行回顾性观察研究。日常捆绑护理的合规性是通过对每项内容的日常记录来确定的：评估疼痛（要素 A）、自发唤醒试验（要素 B1）和自发呼吸试验（要素 B2）、镇静剂选择（要素 C）、谵妄评估（要素 D）、早期动员（要素 E）和家属参与（要素 F）：从护理（47%）、物理治疗（44%）和医生（7%）处获得了 4165 个注册捆绑要素，其中包括 1134 个患者/日（来自 133 名患者）。要素 E 和 C 的符合率分别为 67% 和 40%，而 D、A 和 B2 的符合率分别为 24%、14% 和 11%。B1 和 F 的依从性为 0%。在没有机械通气的患者中，A 和 E 的顺应性更高，而 D 的顺应性与之相似：结论：早期动员的依从性最高，而自发唤醒试验和家属参与的依从性绝对较低。未来的研究应探讨临床实践中各捆绑要素依从性程度不同的原因。
Daily compliance of the ABCDEF liberation bundle for patients in the intensive care unit: A retrospective descriptive study
Introduction: Implementing the ABCDEF bundle has demonstrated improved outcomes in patients with critical illness. This study aims to describe the daily compliance of the ABCDEF bundle in a Chilean intensive care unit.
Methods: Retrospective observational study of electronic clinical records of nursing, physiotherapy, and medical professionals who cared for patients over 18 years of age, admitted to an intensive care unit for at least 24 hours, with or without mechanical ventilation. Daily bundle compliance was determined by considering the daily records for each element: Assess pain (element A), both spontaneous awakening trials (element B1) and spontaneous breathing trials (element B2), choice of sedation (element C), delirium assessment (element D), early mobilization (element E), and family engagement (element F).
Results: 4165 registered bundle elements were obtained from nursing (47%), physiotherapy (44%), and physicians (7%), including 1134 patient/days (from 133 patients). Elements E and C showed 67 and 40% compliance, while D, A, and B2 showed 24, 14 and 11%, respectively. For B1 and F, 0% compliance was achieved. Compliance was higher in patients without mechanical ventilation for A and E, while it was similar for D.
Conclusions: Early mobilization had the highest compliance, while spontaneous awakening trials and family engagement had absolute non-compliance. Future studies should explore the reasons for the different degrees of compliance per bundle element in clinical practice.
期刊介绍：
Medwave is a peer-reviewed, biomedical and public health journal. Since its foundation in 2001 (Volume 1) it has always been an online only, open access publication that does not charge subscription or reader fees. Since January 2011 (Volume 11, Number 1), all articles are peer-reviewed. Without losing sight of the importance of evidence-based approach and methodological soundness, the journal accepts for publication articles that focus on providing updates for clinical practice, review and analysis articles on topics such as ethics, public health and health policy; clinical, social and economic health determinants; clinical and health research findings from all of the major disciplines of medicine, medical science and public health. The journal does not publish basic science manuscripts or experiments conducted on animals. Until March 2013, Medwave was publishing 11-12 numbers a year. Each issue would be posted on the homepage on day 1 of each month, except for Chile’s summer holiday when the issue would cover two months. Starting from April 2013, Medwave adopted the continuous mode of publication, which means that the copyedited accepted articles are posted on the journal’s homepage as they are ready. They are then collated in the respective issue and included in the Past Issues section.
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