• Surui Liang, ChauJanita Pak ChunJPCThe Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong., Suzanne Hoi Shan Lo, Shunling Li, and Mingrong Gao.
• The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong.
• Nurs Crit Care. 2021 Sep 1; 26 (5): 386-396.

BackgroundDelirium affects up to 80% of patients in intensive care units (ICUs) and is associated with higher mortality, physical dependence, and health care costs. The 2018 pain, agitation, delirium, immobility, and sleep guideline recommended ABCDEF care bundle for delirium prevention and management. However, limited information is available regarding the adoption of the care bundle in ICUs in Mainland China.Aims And ObjectivesTo assess the current implementation of the ABCDEF care bundle for delirium prevention as reported by ICU nurses in Mainland China.DesignA cross-sectional study was conducted.MethodsA cross-sectional online survey using a validated questionnaire about the practices of the ABCDEF care bundle was conducted among 334 registered nurses in 167 ICUs of 65 cities in Mainland China.ResultsAlmost 50% of the sampled ICU nurses were unaware of the ABCDEF care bundle, though 86.83% of the surveyed ICUs implemented pain assessments and 95.51% implemented sedation assessments. Nearly half (46.41%) of the surveyed ICUs performed routine spontaneous awaking trials, with 21.26% performing them daily. Spontaneous breathing trials were performed in 38.32% of the surveyed ICUs. Only 47% of the surveyed ICUs routinely monitored patients for delirium. About one-third (38.35%) of the surveyed ICUs were supported by specialist teams that implemented the mobilization programmes. Most ICUs restricted the duration of family visits per day (<0.5 hour: 61.67%; 0.5-2 hours: 23.65%; >2 hours: 3.29%) and only 28.14% of the surveyed ICUs employed dedicated staff to support the families.ConclusionsAlthough most of the surveyed ICUs implemented pain and sedation assessments, many of them did not implement structured delirium assessments. Early mobilization programmes and family participation should be encouraged.Relevance To Clinical PracticePromoting the uses of a reliable delirium assessment tool such as Confusion Assessment Method for Intensive Care Unit patients, building an early mobilization team, and engaging family caregivers in the care plan may contribute to improved patients' clinical outcomes.© 2021 British Association of Critical Care Nurses.

3 keywords...

hide…