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A Systemic Approach: ABCDEF Bundle

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Nursing in Critical Care Setting

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Abstract

ABCDEF bundle is an evidence-based, integrated, systemic, and interdisciplinary approach to the management of mechanically ventilated patients. The acronym ABCDEF stands for the following: ABC, awake and breathing coordination; D, delirium monitoring; E, early mobility and exercise; and F, family involvement.

Spontaneous awakening and breathing trials have been combined into awake and breathing coordination, with the aim to reduce the duration of mechanical ventilation and ICU and hospital length of stay and improve the survival rates. Delirium monitoring improves the recognition of this disorder, but data on pharmacologic treatment are conflicting. Early mobility and exercise may reduce physical dysfunction and delirium rates. Family involvement in patients’ care can improve patient’s process of recovery.

Many institutions have implemented the concept of ABCDEF bundle through different practice guidelines. The main models are promoted by the American Association of Critical-Care Nurses (ACCN) and Society of Critical Care Medicine (SCCM).

In this chapter, the authors will propose a mixed model for the ABCDEF bundle implementation.

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Authors and Affiliations

  1. Anesthesia, Intensive Care and Hub Pain Service, University Hospital of Parma, Parma, Italy

    Matteo Manici

  2. Vita-Salute San Raffaele University, Milan, Italy

    Alessandra Negro

  3. IRCCS San Raffaele Hospital, Milano, Italy

    Alessandra Negro

  4. Emergency & Trauma ICU, University Hospital Careggi, Florence, Italy

    Stefano Bambi R.N., B.S., M.A.S., O.N.N.-C.G.

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  1. Matteo Manici
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  3. Stefano Bambi R.N., B.S., M.A.S., O.N.N.-C.G.
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Manici, M., Negro, A., Bambi, S. (2018). A Systemic Approach: ABCDEF Bundle. In: Nursing in Critical Care Setting. Springer, Cham. https://doi.org/10.1007/978-3-319-50559-6_17

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  • DOI: https://doi.org/10.1007/978-3-319-50559-6_17

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