Table 6.
Sedative Medication Utilization and Delirium Monitoring/Management and Early Exercise/Mobility Implementation
| Variable | Pre ABCDE Bundle N = 146 |
Post ABCDE Bundle N = 150 |
p-value |
|---|---|---|---|
| Sedation received post-enrollment | |||
| Benzodiazepinesa | |||
| Patients treated, n (%) | 91 (62.3%) | 77 (51.3%) | 0.06 |
| Total dose (mg), median (IQR) | 21.2 (3, 87.6) | 17.4 (3, 56.1) | 0.41 |
| Average daily doseb (mg), median (IQR) | 2.8 (1, 12.7) | 1.7 (0.4, 7.8) | 0.09 |
| Opiatesc | |||
| Patients treated, n (%) | 124 (84.9%) | 134 (89.3%) | 0.26 |
| Total dose (mg), median (IQR) | 26.3 (10, 147.2) | 35.8 (14, 126) | 0.70 |
| Average daily doseb (mg), median (IQR) | 5.8 (2, 16.7) | 5.5 (2.2, 14.3) | 0.97 |
| Propofol | |||
| Patients treated, n (%) | 25 (17.1%) | 31 (20.7%) | 0.44 |
| Total dose (mg), median (IQR) | 1003 (150, 5305) | 410 (140, 2310) | 0.50 |
| Average daily doseb (mg), median (IQR) | 83.3 (10, 499.8) | 66.7 (7.7, 419) | 0.64 |
| Dexmedetomidine (ug) | |||
| Patients treated, n (%) | 12 (8.2%) | 16 (10.7%) | 0.47 |
| Total dose (mg), median (IQR) | 1538 (566, 5820.3) | 2500 (332, 3726) | 0.69 |
| Average daily doseb (mg), median (IQR) | 140.3 (88.4, 269.3) | 185.7 (28.4, 294.9) | 0.87 |
| Haloperidol | |||
| Patients treated, n (%) | 11 (7.5%) | 12 (8.0%) | 0.88 |
| Total dose (mg), median (IQR) | 6 (2.5, 19.5) | 17.5 (3.8, 39.3) | 0.24 |
| Average daily doseb (mg), median (IQR) | 0.5 (0.3, 1.3) | 1.3 (0.4, 4.1) | 0.20 |
| Percentage of time CAM-ICU results documented every 8 hours by bedside nursed | ----- | 50 (33.3, 66.7) | |
| Mechanically ventilated (MV) patients, median (IQR) | ---- | 50 (33.3, 66.7) | |
| Non-MV patients, median (IQR) | ----- | 60 (33.3, 68.6) | |
| Delirium anytime per bedside nurse documentation, n (%) | 76 (51%) | ||
| Percentage of time RASS score documented every 8 hours by bedside nurse | 66.3% | 68% | 0.84 0.68 |
| Richmond Agitation-Sedation Scale Score by bedside nurses, mean (SD) | −0.64 (1.1) | −0.59 (1.1) | |
| Physical therapy consults anytime during ICU stay, n (%) | 105 (71.9%) | 113 (75.3%) | 0.50 |
| Mobilized out of bed (OOB) at least once during ICU stay, n (%) | 70 (48%) | 99 (66.0%) | 0.002 |
| Mechanically ventilated patients, n (%) | 44/93 (47.3%) | 57/94 (60.6%) | 0.07 |
| Non mechanically-ventilated patients, N (%) | 26/53 (49.1%) | 42/56 (75%) | 0.005 |
| OOB days/ICU length of stay, median % (IQR) | 33.3 (16.7, 50) | 33.3 (20, 53.9) | 0.64 |
CAM = confusion assessment method; ICU = intensive care unit; IQR = interquartile range; mg = milligram; MV = mechanically ventilated; n = number; OOB = out of bed; ug = microgram.
Expressed in lorazepam equivalents. Includes the following medications: lorazepam, midazolam, clonazepam, diazepam, temazepam. The total dose includes continuous infusions and bolus doses given intravenously, intramuscularly, and orally.
Average daily dose calculated by taking the total dose per subject and dividing by their total days in ICU.
Expressed in morphine equivalents. Includes the following medications: morphine, hydromorphone, and fentanyl. The total dose includes continuous infusions and bolus doses given intravenously, intramuscularly, and orally.
Per the institution’s ABCDE bundle policy, bedside nurses were required to document results of the CAM-ICU every 8 hours.