Critical Care Nurses' Role in Implementing the "ABCDE Bundle" Into Practice
Critical Care Nurses' Role in Implementing the "ABCDE Bundle" Into Practice
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DOI：
10.4037/ccn2012229
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发表时间：
2012-04-01
影响因子：
1.6
通讯作者：
Ely, E. Wesley
中科院分区：
文献类型：
--
作者：
Balas, Michele C.;Vasilevskis, Eduard E.;Ely, E. Wesley
想象一下，在这样一个环境中工作，所有接受机械通气的患者都是清醒、平静和没有精神错乱的。设想在这样一个环境中练习，在这个环境中，非发声患者可以有效地表达他们对更好的疼痛控制、重新定位或情感安慰的需求。想象一个重症监护病房，在那里，由护士领导的跨专业团队实施以证据为基础、以患者为中心的护理，专注于保护和/或恢复客户的身体、功能和神经认知能力。最近提出的重症监护病房实践捆绑可能会将当前的实践环境推向这种理想的环境。觉醒和呼吸协调、妄想症监测和管理以及早期活动(ABCDE)捆绑了与重症监护病房中的精神错乱、不动、镇静/止痛和呼吸机管理相关的最佳证据，用于日常临床实践。(重症监护护士。2012；32[2]：35-38，40-48)
Imagine working in an environment where all patients undergoing mechanical ventilation are alert, calm, and delirium free. Envision practicing in an environment where nonvocal patients can effectively express their need for better pain control, repositioning, or emotional reassurance. Picture an intensive care unit where a nurse-led, interprofessional team practices evidence-based, patient-centered care focused on preserving and/or restoring their clients' physical, functional, and neurocognitive abilities. A recently proposed bundle of practices for the intensive care unit could advance the current practice environment toward this idealized environment. The Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle incorporates the best available evidence related to delirium, immobility, sedation/analgesia, and ventilator management in the intensive care unit for adoption into everyday clinical practice. (Critical Care Nurse. 2012;32[2]:35-38,40-48)