• Michele C Balas, Eduard E Vasilevskis, William J Burke, Leanne Boehm, Brenda T Pun, Keith M Olsen, Gregory J Peitz, and E Wesley Ely.
• University of Nebraska Medical Center, College of Nursing, Omaha 68198-5330, USA. mbalas@unmc.edu
• Crit Care Nurse. 2012 Apr 1; 32 (2): 35-8, 40-7; quiz 48.

AbstractImagine working in an environment where all patients undergoing mechanical ventilation are alert, calm, and delirium free. Envision practicing in an environment where nonvocal patients can effectively express their need for better pain control, repositioning, or emotional reassurance. Picture an intensive care unit where a nurse-led, interprofessional team practices evidence-based, patient-centered care focused on preserving and/or restoring their clients' physical, functional, and neurocognitive abilities. A recently proposed bundle of practices for the intensive care unit could advance the current practice environment toward this idealized environment. The Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle incorporates the best available evidence related to delirium, immobility, sedation/analgesia, and ventilator management in the intensive care unit for adoption into everyday clinical practice.

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