The DOI matches its Crossref record; 37 of the 37 references it cites were found in a registry or an index.
Improving Hospital Survival and Reducing Brain Dysfunction at Seven California Community Hospitals: Implementing PAD Guidelines Via the ABCDEF Bundle in 6,064 Patients*
Abstract
Objectives: To track compliance by an interprofessional team with the Awakening and Breathing Coordination, Choice of drugs, Delirium monitoring and management, Early mobility, and Family engagement (ABCDEF) bundle in implementing the Pain, Agitation, and Delirium guidelines. The aim was to study the association between ABCDEF bundle compliance and outcomes including hospital survival and delirium-free and coma-free days in community hospitals. Design: A prospective cohort quality improvement initiative involving ICU patients. Setting: Seven community hospitals within California’s Sutter Health System. Patients: Ventilated and nonventilated general medical and surgical ICU patients enrolled between January 1, 2014, and December 31, 2014. Measurements and Main Results: Total and partial bundle compliance were measured daily. Random effects regression was used to determine the association between ABCDEF bundle compliance accounting for total compliance (all or none) or for partial compliance (“dose” or number of bundle elements used) and outcomes of hospital survival and delirium-free and coma-free days, after adjusting for age, severity of illness, and presence of mechanical ventilation. Of 6,064 patients, a total of 586 (9.7%) died before hospital discharge. For every 10% increase in total bundle compliance, patients had a 7% higher odds of hospital survival (odds ratio, 1.07; 95% CI, 1.04–1.11; p < 0.001). Likewise, for every 10% increase in partial bundle compliance, patients had a 15% higher hospital survival (odds ratio, 1.15; 95% CI, 1.09–1.22; p < 0.001). These results were even more striking (12% and 23% higher odds of survival per 10% increase in bundle compliance, respectively, p < 0.001) in a sensitivity analysis removing ICU patients identified as receiving palliative care. Patients experienced more days alive and free of delirium and coma with both total bundle compliance (incident rate ratio, 1.02; 95% CI, 1.01–1.04; p = 0.004) and partial bundle compliance (incident rate ratio, 1.15; 95% CI, 1.09–1.22; p < 0.001). Conclusions: The evidence-based ABCDEF bundle was successfully implemented in seven community hospital ICUs using an interprofessional team model to operationalize the Pain, Agitation, and Delirium guidelines. Higher bundle compliance was independently associated with improved survival and more days free of delirium and coma after adjusting for age, severity of illness, and presence of mechanical ventilation.
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Self-citationSessler, C. N., Gosnell, M. S., Grap, M. J., Brophy, G. M., O'Neal, P. V., Keane, K. A., Tesoro, E. P., & Elswick, R. K. (2002) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.2107138 · Cited by 3,695
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Self-citationDelirium as a Predictor of Mortality in Mechanically Ventilated Patients in the Intensive Care Unit
Ely, E. W. (2004) · JAMA · doi:10.1001/jama.291.14.1753 · Cited by 3,073
Self-citationKress, J. P., Pohlman, A. S., O'Connor, M. F., & Hall, J. B. (2000) · New England Journal of Medicine · doi:10.1056/nejm200005183422002 · Cited by 2,981
Long-term cognitive impairment after critical illness
Pandharipande, P. P., Girard, T. D., Jackson, J. C., Morandi, A., Thompson, J. L., Pun, B. T., Brummel, N. E., Hughes, C. G., Vasilevskis, E. E., Shintani, A. K., et al. (2013) · New England Journal of Medicine · doi:10.1056/nejmoa1301372 · Cited by 2,842
Self-citationOne-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome
Herridge, M. S., Cheung, A. M., Tansey, C. M., Matte-Martyn, A., Diaz-Granados, N., Al-Saidi, F., Cooper, A. B., Guest, C. B., Mazer, C. D., Mehta, S., et al. (2003) · New England Journal of Medicine · doi:10.1056/nejmoa022450 · Cited by 2,334
Girard, T. D., Kress, J. P., Fuchs, B. D., Thomason, J. W., Schweickert, W. D., Pun, B. T., Taichman, D. B., Dunn, J. G., Pohlman, A. S., Kinniry, P. A., et al. (2008) · The Lancet · doi:10.1016/s0140-6736(08)60105-1 · Cited by 2,055
Self-citationEly, E. W., Truman, B., Shintani, A., Thomason, J. W. W., Wheeler, A. P., Gordon, S., Francis, J., Speroff, T., Gautam, S., Margolin, R., et al. (2003) · JAMA · doi:10.1001/jama.289.22.2983 · Cited by 1,707
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Wilson, J. E., Mart, M. F., Cunningham, C., Shehabi, Y., Girard, T. D., MacLullich, A. M. J., Slooter, A. J. C., & Ely, E. W. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-00223-4 · Cited by 1,200
Self-citationVentilator-associated pneumonia in adults: a narrative review
Papazian, L., Klompas, M., & Luyt, C.-E. (2020) · Intensive Care Medicine · doi:10.1007/s00134-020-05980-0 · Cited by 1,010
Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness
Girard, T. D., Exline, M. C., Carson, S. S., Hough, C. L., Rock, P., Gong, M. N., Douglas, I. S., Malhotra, A., Owens, R. L., Feinstein, D. J., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1808217 · Cited by 573
Self-citationPun, B. T., Badenes, R., Heras La Calle, G., Orun, O. M., Chen, W., Raman, R., Simpson, B.-G. K., Wilson-Linville, S., Hinojal Olmedillo, B., Vallejo de la Cueva, A., et al. (2021) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(20)30552-x · Cited by 522
Self-citationThe ABCDEF Bundle: Science and Philosophy of How ICU Liberation Serves Patients and Families
Ely, E. W. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002175 · Cited by 514
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Metadata
- Authors
- Barnes-Daly, M. A., Phillips, G., & Ely, E. W.
- Venue
- Critical Care Medicine
- Published
- 2017-02
- Volume
- 45
- Issue
- 2
- Pages
- 171-178
- ISSN
- 0090-3493 (ISSN-L)
- OpenAlex
- W2557094083
- Cited by
- 425
- References
- 37
- FWCI
- 33.39
- Type
- journal article
- Language
- en
- Open access
- closed
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