ABCDE, but in That Order? A Cross-Sectional Survey of Michigan Intensive Care Unit Sedation, Delirium, and Early Mobility Practices

Rationale: A bundled approach to intensive care unit (ICU) care known as “Awakening and Breathing Coordination, Delirium monitoring/management, and Early exercise/mobility” (ABCDE) has been proposed, with evidence supporting individual interventions as well as the bundle as a whole. Few data exist on the bundle’s implementation and efficacy in community practice.Objectives: To evaluate self-reported rates of implementation of ABCDE components and their association with outcomes in a state-wide quality improvement collaborative.Methods: A written survey was administered to representatives attending the 2012 annual meeting of the Michigan Health and Hospital Association’s Keystone ICU collaborative. Respondents reported on their practices regarding spontaneous awakening trials, delirium assessments, and early mobility.Measurements and Main Results: There were 212 respondents, a 76% response rate. Wide variation in focus was noted across the assessed components of ABCDE. Only 12% reported having implemented ...