• Mandy Bounds, Stacey Kram, Karen Gabel Speroni, Kim Brice, Mary Anne Luschinski, Stephanie Harte, and Marlon G Daniel.
• Mandy Bounds is a former nurse manager at University of Maryland Shore Medical Center at Dorchester, Cambridge, Maryland. Stacey Kram is a former nurse manager at University of Maryland Shore Regional Health, Easton, Maryland. Karen Gabel Speroni is chair of the nursing research council, University of Maryland Shore Regional Health. Kim Brice is an intensive care unit (ICU)/telemetry clinical educator/ICU staff nurse at University of Maryland Shore Medical Center at Easton, Easton, Maryland. Mary Anne Luschinski is an ICU staff nurse at University of Maryland Shore Medical Center at Easton. Stephanie Harte is a former physical therapist at University of Maryland Shore Medical Center at Dorchester and Easton. Marlon G. Daniel is a biostatistician at University of Maryland Shore Regional Health. mbounds@umm.edu.
• Am. J. Crit. Care. 2016 Nov 1; 25 (6): 535-544.

BackgroundThe ABCDE bundle incorporates multidisciplinary measures to improve and/or preserve patients' physical, functional, and neurocognitive status through awakening and breathing coordination, delirium prevention and management, and early physical mobility.ObjectivesTo quantify the prevalence and duration of delirium in patients in the intensive care unit (ICU) before and after implementation of the ABCDE bundle.MethodsDelirium prevalence was defined as the percentage of patients who had at least 1 positive delirium score on the Intensive Care Delirium Screening Checklist (ICDSC) during the ICU stay; delirium duration was the number of days during the ICU stay that a positive ICDSC score was noted. Retrospective data were collected from before and after implementation of the ABCDE bundle.ResultsOf the 159 records reviewed (80 before and 79 after bundle implementation), most were for white men (mean age, 66.3 years). After implementation of the ABCDE bundle, the prevalence of delirium decreased significantly (from 38% to 23%, P = .01) and the mean number of days of delirium decreased significantly (from 3.8 to 1.72 days, P < .001). The number of patients with delirium-free stays increased after bundle implementation.ConclusionsImplementation of the ABCDE bundle led to significant decreases in the prevalence and duration of delirium in ICU patients.©2016 American Association of Critical-Care Nurses.

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