Abstract

Delirium is an acute dysfunction of the brain that occurs in up to eighty percent of critically ill patients which has been associated with increased morbidity, mortality and long-term cognitive deficits. In an effort to reduce symptoms associated with Intensive Care Unit (ICU) acquired delirium, leading critical care researchers created the Awakening and Breathing Coordination, Delirium Monitoring/Management and Early mobility (ABCDE) bundle (Balas et al, 2012). Through an integrative literature review, the aim of this scholarly inquiry paper is to determine the efficacy of the ABCDE bundle in reducing the incidence of delirium in critically ill patients and provide supporting recommendations for ongoing use of this clinical tool. Using PubMed, CINAHL, and Google Scholar, eight research studies of varying levels of evidence were reviewed and analyzed, including one clinical practice guideline and one systematic review. A conceptual map was created to illustrate the results of the literature review and provide future recommendations. The literature review did not provide definitive results that proved a reduction in episodes of delirium when the ABCDE bundle was implemented but patient outcomes, such as mortality and readmission rates improved, warranting consideration of the ABCDE bundle for clinical practice. Successful implementation of the ABCDE bundle requires a true interdisciplinary approach by the healthcare team and would be best implemented using an evidence-based practice (EBP) framework or model such as the Johns Hopkins Nursing Evidence-Based Practice Model. By utilizing this model, a step-by-step recommendation will be made for pilot implementation of the ABCDE bundle.

Date of Completion of Thesis/SIP

Fall 11-25-2019

Document Type

Scholarly Inquiry Paper (SIP)

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Scott Faust

Second Advisor

Kimberly Langer

Included in

Nursing Commons

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