Abbreviations: ABCDE=Awakening and Breathing trial Coordination, Delirium assessment/management, Early mobility, DE=Delirium assessment/management and Early mobility
101 patients were observed for adherence over 561 ventilator ICU days and 191 ventilator-free ICU days across 10 ICUs (6 medical units, 4 surgical units). Overall ABCDE bundle adherence (72% represented by orange dash line) was less than DE bundle adherence (97% represented by orange dash line) in all units (p<0.001) as well as when compared by medical (p<0.001) and surgical units (p<0.001). Overall ABCDE bundle adherence was not statistically significantly greater in medical vs. surgical units (p=0.059).
**NOTE explaining the rationale behind ABCDE vs. DE adherence metrics: The ABCDE Bundle definitions used in this investigation were defined at the time of the initiation of this study, and have subsequently been modified as part of the ICU Liberation initiative to include the current ABCDEF Bundle (www.icudelirium.org and www.iculiberation.org). According to the originally defined steps, ABC are not necessarily relevant in non-ventilated patients, and for our study we anticipated that most ICUs were focusing on just the DE steps in non-ventilated patients. Thus it was decided a priori that we would assess “DE Adherence” for non-ventilated patients.
*Hospital 5 and 6 surgical ICUs did not participate in the study. Hospital 5 did not have DE bundle data, all measured bundle days were on the ventilator.