Degree Name

Master of Science in Nursing (MSN)

Document Type

Major Paper


Zvart Onanian School of Nursing



Date of Original Version



Background: Intensive Care Unit (ICU) survivorship is often marked by lasting complications such as delirium, morbidity, debilitation, and increased incidence of 6-month mortality. Aside from direct organ and life support through critical illness periods, this survivorship remains a key area of opportunity for improved outcomes through evidenced-based intervention. One such intervention is the ICU Liberation Bundle, a package of elements proven to improve survivor outcomes. The literature is abundant with evidence for its effectiveness, but also speaks to lack of universal implementation and whole-bundle compliance at the point of care.

Purpose/Specific Aims: To explore barriers to ICU Liberation Bundle implementation and overall nursing attitudes towards the bundle and its five elements.

Methods:,/b> Education sessions on ICU Liberation Bundle to ICU point of care nursing staff were followed by focus group style interviews using open-ended questions to explore perceived barriers and standard care divergence from the bundle. Analysis was conducted using inductive thematic analysis as described by Nowell et al. (2017)

Results: Nurses have mostly positive perception of the bundle and its elements. They consider the early mobility element as the most divergent from their current practice and commonly identified staffing/resource availability and concerns for patient safety as barriers to implantation. Family involvement was also cited as divergent with similar barriers to implementation.

Conclusion: Nurses agree with most of the outcome-centered mission and elements of the bundle but perceive staffing as a barrier to full implementation. Further investigation is warranted to confirm or refute these findings.

Hobbins Posterppt.ppt (354 kB)
Powerpoint Presentation Poster