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Effectiveness of the ABCDE Bundle on ICU-acquired Delirium and Weakness among Mechanically Ventilated Patients

Asmaa A. Ebrahim, Naglaa M. El Mokadem, Asmaa H. Abd-Elhy, Yasser F. Ibrahim

Abstract


Background: The ABCDE bundle integrates evidence-based practice to improve and conserve
patients’ physical, and neurocognitive status through awakening and breathing coordination,
delirium assessment, and mobility. Aim of the study: to examine the effectiveness of ABCDE bundle on
ICU-acquired delirium and weakness among mechanical ventilation (MV) patients. Setting: The
Surgical Intensive Care Unit (SICU) at Menoufia University Hospital. Sample: A convenient sample
of 100 mechanically ventilated patients who were admitted to the SICU. Design: A quasi-
experimental design was utilized. Tools: (1) A Semi Structured Demographic Questionnaire, (2)
APACHE II scale, (3) The Charlson Comorbidity Index (CCI), (4) Richmond Agitation–Sedation
Scale (RASS), (5) Confusion Assessment Method in the ICU (CAM-ICU), and (6) Medical Research
Council Manual Muscle Testing (MRC-MMT) scale. Results: there was a statistically significant
reduction in the mean score of delirium features in the study group compared to the control group
(p<0.001). Also, the majority of the study group experienced less ICU-acquired weakness (80.0%)
compared to the control group (50.0%) post intervention. Conclusion: ABCDE bundle intervention
has a positive effect on reducing ICU-acquired delirium and weakness among mechanically ventilated
patients. Recommendation: ABCDE bundle intervention should be carried out routinely for managing
patients on mechanical ventilation.


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