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Implement the A-F elements of the ICU Liberation Bundle to improve outcomes while transforming culture.
The Society of Critical Care Medicine's (SCCM) ICU Liberation Bundle (A-F) is unique because it can be applied to every patient, every day, by the full team. Your implementation does not have to be perfect right away. Small changes make a big difference.
By fostering a holistic approach to treating patients and improving ICU team communication, the ICU Liberation Bundle has been proven in multiple studies involving more than 20,000 patients to:
Decrease the likelihood of hospital death within seven days by 68%
Reduce delirium and coma days by 25% to 50%
Reduce physical restraint use by more than 60%
Cut ICU readmissions in half
Reduce discharges to nursing and rehabilitation facilities by 40%
The “A” element of the ICU Liberation Bundle consists of assessing, preventing, and managing pain. Pain is an unpleasant sensory and emotional experience that is best reported by the person who is experiencing it, although self-reporting can be a challenge in the ICU. The inability to communicate verbally does not negate the possibility that a patient is experiencing pain.
The PADIS guidelines recommend:
Opioids Commonly Used in the Adult ICU:
Abbreviations: CI = continuous infusion, LD = loading dose.
2018 PADIS Guidelines for Nonopioid Analgesia:
The “F” element of the ICU Liberation Bundle consists of family engagement and empowerment. The “F” element focuses on promoting family presence in the ICU and identifying strategies to engage and empower families. Engaging families in the care of their loved one during critical illness has positive impact on quality and safety and can decrease anxiety, confusion, and agitation.
Family- and patient-centered care focuses on the following characteristics:
A high-level overview of each bundle element that demonstrates bedside tools.
The SCCM Hosted Training Team can provide details about bringing training to your institution.