Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper

School

School of Nursing

Department

Nursing

Date of Original Version

5-2017

Abstract

It is well documented that bedrest has adverse outcomes for hospitalized patients. This is especially true for critically ill patients due to life support measures, invasive catheters, and mechanical ventilation. Consequences associated with bedrest in critical care patients include venous thromboembolism, ventilator associated pneumonia, pressure ulcer development, and muscle weakness. Respiratory muscle weakness is associated with prolonged ventilator support and delayed extubation. The Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle uses evidence based practice to prevent and treat ICU acquired delirium and weakness. The bundle aims to do this by standardizing care processes in collaboration with the ICU team to promote early mobility in ventilated patients. The purpose of this research study was to determine if the implementation of an early mobility protocol decreased the number of ventilator days for patients who receive mechanical ventilation. A retrospective chart review was conducted at a 16 bed ICU. Group A included 30 subjects (n=30) who were treated pre implementation of the ABCDE bundle and Group B included 39 (n=39) subjects who were treated post implementation of the ABCDE bundle. There were less average ventilator days found in Group A in comparison to Group B. Additionally, there was a significant difference found in the ICU length of stay pre implementation (M=9.4, SD=4.4) and post implementation (M=5.7, SD=2.6) of the ABCDE bundle for early mobility, t (65) =4.3, p = 0.00005. The APRN can use the evidence in the ABCDE bundle to guide care to critically ill patients that are mechanically ventilated. Utilizing the ABCDE bundle additionally allows the APRN to be instrumental in improving patient outcomes through interdisciplinary collaboration.

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