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This article was first published in the Summer 2021 issue of Critical Connections. This article highlights unique aspects of ICU Liberation in relevant patient populations and provides guidance toward successful liberation. Three separate teams in neurologic and cardiovascular ICUs share their experiences with implementing the ICU Liberation Bundle.
Joanna L. Stollings, PharmD, FCCP, FCCM, and Devin N. Holden, PharmD, BCPS, BCCCP, summarize how pharmacists can play an important role in the development and implementation of each element of the ICU Liberation Bundle (A-F).
E. Wesley Ely, MD, MPH, FCCM, discusses the ICU Liberation Bundle: The Science Behind Liberating ICU Patients and Families.
These teaching slides address implementing the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines. This presentation addresses implementing the portion of the guidelines related to sleep.
These teaching slides address implementing the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines. This presentation addresses implementing the portion of the guidelines related to sedation.
These teaching slides address implementing the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines. This presentation addresses implementing the portion of the guidelines related to pain.
These teaching slides address implementing the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines. This presentation addresses implementing the portion of the guidelines related to immobility.
These teaching slides address implementing the 2018 Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines. This presentation addresses implementing the portion of the guidelines related to delirium.
Mastering Intensive Care Podcast is a podcast focused on conversations to inspire intensive care clinicians to become the best they can be in the practice of intensive care. In episode 33, Wes Ely, MD, discusses the ABCDEF Bundle.
The Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU, known as the PADIS Guidelines, are an update to the 2013 Pain, Agitation, Delirium Guidelines.
Guidelines for Family-Centered Care in the Neonatal, Pediatric, and Adult ICU aim to provide clinicians with evidence-based strategies to optimize the support of the family of critically ill patients in the ICU.
In this session from the 46th Critical Care Congress, experts in the field discuss rehabilitation in the ICU.
Early Progressive Mobility in the ICU – AACN Clinical Scene Investigator Academy Project, is the latest webcast from the Society of Critical Care Medicine’s (SCCM) ICU Liberation series, held in collaboration with the American Association of Critical-Care Nurses (AACN) and Project Dispatch, funded by the Agency for Healthcare Research and Quality.
In this excerpt from the Society of Critical Care Medicine's 43rd Critical Care Congress, leaders from the ICU Liberation initiative discuss strategies for improving outcomes and Identify strategies and barriers to guideline implementation
An overview of the early mobility program at University of California, San Francisco that includes information about: Staffing and Equipment, Barriers to Initiating Early Mobilization, and steps for early mobilization.
A multiprofessional and multidisciplinary approach to implementing early mobility in the intensive care unit (ICU). Early mobility is the E Element of the ABCDEF Bundle.
Assessment and Treatment Strategies for Early Mobility.
A Comparison of Three ICU Early Mobility Quality Improvement Projects. Early mobility is the E Element of the ABCDEF Bundle.
Understand the barriers to early mobility in the ICU and solution strategies. Early mobility is the E Bundle of the ABCDEF Bundle.
A delirium protocol shared by Sutter Health.
Delirium is frequently found in critically ill adults, affecting patient outcomes both during and after the intensive care unit (ICU) stay.
This video demonstrates the CAM-ICU Delirium screening test for intensive care patients. It is quick, noninvasive and easy to do.
Intensive Care Delirium Screening Checklist (ICDSC)
This is a training manual for physicians, nurses and other healthcare professionals who wish to use the Confusion Assessment Method for the ICU (CAM-ICU).
The CAM-ICU Flowsheet can be used to assess adult ICU patients for delirium in accordance with the PAD Guidelines.
The CAM-ICU is a delirium monitoring instrument for ICU patients in accordance with the PAD Guidelines.
A presentation from the 2012 Critical Care Congress on the Clinical Practice Guidelines on Pain, Agitation, and Delirium (PAD).
Sedation Agitation Scale (SAS) Match behavioral observations with scale descriptors. Each descriptor is matched with an agitation category.
Richmond Agitation Sedation ranks agitation and possibility for sedation. This tool can be used in the implementation of the C Bundle of the ABCDEF Bundle.
Michael J. Cawley, PharmD, RRT, CPFT, FCCM, and Kenneth D. Hargett, MHA, RRT, FAARC, FCCM, review spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT) to reduce the intensive care unit (ICU) length of stay (LOS) and to help improve ICU outcomes.
In this session, Laurie Wilson, RN, MSN, and Christina Ycaza-Gutierrez, RN, BSN, CCRN, explore the team’s journey throughout the execution of the project and review how project implementation goals were achieved.
This presentation discusses strategies for implementing the PAD guidelines. It reviews the Wake Up and Breathe protocol.
Wake Up and Breathe Protocol for Spontaneous Awakening Trials (SATs) and Spontaneous Breathing Trials (SBTs)
This webcast provides an overview of the landscape of pain assessment and pain management in ICU patients within the context of the ABCDEF bundle, and offer suggestions for interventions.
In this webcast from the Society of Critical Care Medicine's (SCCM) Project Dispatch series, The Impact of Pet and Music Therapy on the Critically Ill, expert faculty will share their unique experiences with integrative therapies for patients and families in the ICU.
Music Therapy and AMTA can be used as nonpharmacologic treatments for pain for patients, including those in the intensive care unit (ICU).
Healing Touch is a relaxing, nurturing, heart-centered energy therapy that uses gentle, intentional touch that assists in balancing physical, emotional, mental, and spiritual well-being. Alternative therapies can be used as nonpharmacologic treatments for pain for patients, including those in the intensive care unit (ICU).
Pharmacology of Nonopiate Analgesics. This chart can be used to help treat pain for patients in the intensive care unit (ICU).
Pharmacology of Opiate Analgesics. This chart can be used to help treat pain for adult patients in the intensive care unit (ICU).
Critical-Care Pain Observation Tool can be used to assess pain in adults, including those in the intensive care unit (ICU). This video offers instructions on how to use the Critical-Care Pain Observation Tool.
Critical-Care Pain Observation Tool can be used to assess pain in adults, including those in the intensive care unit (ICU). It can be used in the A Element of the ABCDEF Bundle.
The Behavioral Pain Scale (BPS) can be used to assess pain in in adults, including those in the intensive care unit (ICU). This poster helps train clinicians on how to use the BPS Scale for intubated and non-intubated patients. It can be used in the A Element of the ABCDEF Bundle.
The Behavioral Pain Scale (BPS) can be used to assess pain in in adults, including those in the intensive care unit (ICU). It can be used in the A Element of the ABCDEF Bundle. It can be used for intubated patients and nonintubated patients.
The Numeric Pain Rating Scale (NPRS) can be used to assess pain in adults, including those in the intensive care unit (ICU). It can be used in the A Element of the ABCDEF Bundle.
James C. Jackson, Psy.D, assistant professor at Vanderbilt University, discusses Post-Intensive Care Syndrome (PICS), a condition that affects survivors of critical care illness. He defines PICS, examines how PICS affects patients and families, and identifies common ICU practices that lead to the development of PICS
Identify the building blocks for creating a successful ICU Liberation collaborative focused on implementing the ABCDEF Bundles.
Mary Ann Barnes-Daly, RN, BSN, CCRN, DC, and Juliana Barr, MD, FCCM, provide a strategy for intensive care unit (ICU) teams striving to implement the new ABCDEF bundle.
Interprofessional Team Coaching in the ICU webcasts were conducted for interprofessional teams (IPTs) working together to implement the ABCDEF Bundle.
Implementation of the PAD Guidelines using an Inter-Professional Team Model by Mary Ann Daly
In this excerpt from the Society of Critical Care Medicine's 43rd Critical Care Congress, leaders from the ICU Liberation initiative discuss strategies for improving outcomes and identify strategies and barriers to guideline implementation.
Alison Clay, MD, shares her experience as an ICU survivor and her experience with post-intensive care syndrome (PICS).
Sutter Health and the Gordon and Betty Moore Foundation provides two videos that examine incorporation of the ABCDE bundle during multiprofessional rounds in the intensive care unit.
Implement the ICU Liberation ABCDEF Bundle to help reduce delirium, improve pain management, and reduce long-term consequences for adult intensive care unit (ICU) patients. This .zip file includes all the teaching slides to implement each element of the ABCDEF Bundle
This rounding tool can help you implement the ABCDEF Bundle.
The MICU rounding tool can help you implement the ABCDEF Bundle.
The F Element of the ABCDEF Bundle addresses patient and family engagement in the intensive care unit (ICU).
This guide can help clinicians implement the E Element of the ABCDEF Bundle: Early Mobility. Understand the deficits ICU survivors face and describe the benefits of early mobility in ICU, identify strategies for successful implementation of early mobilization program.
Assess, Prevent, and Manage Delirium: This presentation aims to help implement the D Element of the ABCDEF Bundle.
Choice of analgesia and sedation offers guidance for a medication regimen for the management of pain and agitation in critically ill adults, consistent with the PAD Guidelines recommendations.
The B Element of the ABCDEF Bundle relates to Both Spontaneous Awakening Trials and Spontaneous Breathing Trails. This guide reviews current evidence related to the hazards of deep sedation and the benefits of a coordinated SAT and SBT approach.
This ICU Liberation presentation compares pain assessment tools, identifies challenges for effective pain assessment, pain prevention, and pain management. Use this to help implement the A Element of the ABCDEF Bundle.