Although the Awakening and Breathing Coordination, Delirium assessment, and Early exercise/mobility (ABCDE) bundle may be effective, individual components of ABCDE may not be implemented as intended. We examined the use of daily interruption of sedation (DIS) and early mobility, looking for an association between these bundle elements. Despite the growing use of DIS and early mobility, the two do not seem to be adopted together, with serious implications for the effectiveness of the ABCDE bundle.
University of Michigan School of Nursing, Ann Arbor (Dr Manojlovich); VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor (Mr Ratz); Division of Healthcare Associated Infections, Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, Maryland (Dr Miller); and VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor (Dr Krein).
Correspondence: Milisa Manojlovich, PhD, RN, CCRN, University of Michigan School of Nursing, 400 N. Ingalls, Room 4306, Ann Arbor, MI 48109 (firstname.lastname@example.org).
The authors declare no conflicts of interest.
This project was supported by the Blue Cross Blue Shield of Michigan Foundation grant 1907.II and the US Department of Veterans Affairs National Center for Patient Safety. Dr Miller participated in this project as an outside activity. The views expressed are those of the authors and no official endorsement by the Agency for Healthcare Research and Quality, US Department of Health and Human Services, Department of Veterans Affairs, or Federal government is intended or should be inferred.
Accepted for publication: June 18, 2016
Published ahead of print: August 1, 2016