Audrey Brockman, BSN, , CCRN
Graduate Student
The Ohio State University College of Nursing
Columbus, Ohio
Disclosure information not submitted.
Jin Jun, PhD, RN
Assistant Professor
The Ohio State University, United States
Disclosure information not submitted.
Michele Balas, CCRN-K, PhD, RN
Assoc. Dean Nursing Research
University of Nebraska Medical Center College of Nursing
Hamilton, NJ
Disclosure information not submitted.
Title: A Multicenter Study of Strategies Used to Facilitate Adoption of the ABCDEF Bundle
Introduction: Evidence suggests that critically ill adults treated with the ABCDEF bundle experience significant improvements in a variety of patient-centered outcomes. However, few ICU patients routinely receive this potentially life-saving, interprofessional intervention. The purpose of this study was to identify which strategies clinicians use to facilitate ABCDEF bundle adoption and assess perceptions of how helpful, acceptable, feasible, and costly these strategies were to implement.
Methods: This multicenter study used a convenience sample of ICU clinicians that participated in the Society of Critical Care Medicine’s ICU Liberation Collaborative. Participants were asked to complete an online survey containing the 73 implementation strategies offered in the Expert Recommendations for Implementing Change (ERIC) project. Clinicians were asked if their institution used each strategy in their implementation efforts (yes/no), and if used, prompted to assess how helpful, acceptable, feasible, and costly the strategy was to implement via a 5-point Likert scale. Results were analyzed using descriptive statistics.
Results: Nineteen of 68 ICUs (27.9%) completed the survey and are included in final analysis. The most used strategies included conducting educational meetings (94.7%, n=18), using an advisory board/workgroup (94.7%, n=18), providing ongoing training (89.5%, n=17), developing educational materials (89.5%, n=17), distributing educational materials (84.2%, n=16), reexamining implementation (84.2%, n=16), and providing audit/feedback (84.2%, n=16). Ten strategies were not used at all. The strategies reported as most helpful, acceptable, and feasible were conducting educational meetings (94%, n=17), using an advisory board/workgroup (77%, n=14), and developing educational materials (70%, n=17) respectively. The least costly strategy was reminding clinicians (75%, n=12).
Conclusions: Training/educating stakeholders were the most used and using financial strategies/making changes to infrastructure the least used strategies to facilitate ABCDEF bundle adoption in everyday ICU care. Interestingly, the most used strategies were not necessarily deemed the most helpful, acceptable, feasible, or costly by clinicians. These results suggest future research is needed to develop targeted ABCDEF bundle implementation strategies.