Presentation Notes

Quality Improvement podium presentation at Empowering Nursing Excellence: Recognizing the Value and Impact of Nurses, Advocate Health Midwest Region Nursing Research & Professional Development Conference 2023; November 15, 2023; virtual.

Abstract

Background:

The ventilator length of stay index (VLOS) is defined as the ratio of actual/predicted ventilator days. Amid the COVID-19 pandemic, the Medical Intensive Care Unit rate increased to 1.62 and remained above the 0.99 goal.

Problem:

Despite the use of multiple assessment tools and evidence-based practices to help identify patients’ readiness for extubation, the performance levels in the medical intensive care unit remain above target goal. The aim of this project was to implement the evidence based ABCDEF bundle to improve the assessment and management of patient’s pain, agitation, delirium, early mobility, and family engagement while on mechanical ventilation to decrease ventilator days.

Method:

The Plan Do Study Act (PDSA) cycle with the Model for Improvement framework was used for implementation of the bundle. After education to Medical Intensive Care Unit interprofessional team, bundle compliance was reviewed/monitored through chart audits, providing support, and real time re-education.

Conclusions/Results:

The ventilator length of stay index remained below 0.99 target goal after bundle implementation, with 0.64 in October, 0.68 in November, and 0.89 in December respectively. Data was presented during key stakeholder meetings to address barriers and celebrate wins.

Clinical implications for practice:

By adopting all elements of the ABCDEF bundle, the interprofessional team can decrease ventilator length of stay, and improve knowledge, collaboration, and confidence in the decision - making process to improve patient outcomes. Continue to monitor compliance for sustainability via chart audits, and provide re-education as needed in real time.Reinforce knowledge of ABCDEF bundle via Donna Wright Competency Model for nursing staff.

Document Type

Oral/Podium Presentation

Publication Date

11-15-2023


 

Share

COinS
 
Nov 15th, 12:00 AM

Decreasing ventilator days in medical intensive care unit by implementing ABCDEF bundle

Background:

The ventilator length of stay index (VLOS) is defined as the ratio of actual/predicted ventilator days. Amid the COVID-19 pandemic, the Medical Intensive Care Unit rate increased to 1.62 and remained above the 0.99 goal.

Problem:

Despite the use of multiple assessment tools and evidence-based practices to help identify patients’ readiness for extubation, the performance levels in the medical intensive care unit remain above target goal. The aim of this project was to implement the evidence based ABCDEF bundle to improve the assessment and management of patient’s pain, agitation, delirium, early mobility, and family engagement while on mechanical ventilation to decrease ventilator days.

Method:

The Plan Do Study Act (PDSA) cycle with the Model for Improvement framework was used for implementation of the bundle. After education to Medical Intensive Care Unit interprofessional team, bundle compliance was reviewed/monitored through chart audits, providing support, and real time re-education.

Conclusions/Results:

The ventilator length of stay index remained below 0.99 target goal after bundle implementation, with 0.64 in October, 0.68 in November, and 0.89 in December respectively. Data was presented during key stakeholder meetings to address barriers and celebrate wins.

Clinical implications for practice:

By adopting all elements of the ABCDEF bundle, the interprofessional team can decrease ventilator length of stay, and improve knowledge, collaboration, and confidence in the decision - making process to improve patient outcomes. Continue to monitor compliance for sustainability via chart audits, and provide re-education as needed in real time.Reinforce knowledge of ABCDEF bundle via Donna Wright Competency Model for nursing staff.

 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.