Article ; Online: Multicentre implementation of a quality improvement initiative to reduce delirium in adult intensive care units: An interrupted time series analysis.
2024 Volume 81, Page(s) 154524
Abstract: Purpose: The ABCDEF bundle may improve delirium outcomes among intensive care unit (ICU) patients, however population-based studies are lacking. In this study we evaluated effects of a quality improvement initiative based on the ABCDEF bundle in adult ... ...
| Abstract | Purpose: The ABCDEF bundle may improve delirium outcomes among intensive care unit (ICU) patients, however population-based studies are lacking. In this study we evaluated effects of a quality improvement initiative based on the ABCDEF bundle in adult ICUs in Alberta, Canada. Material and methods: We conducted a pre-post, registry-based clinical trial, analysed using interrupted time series methodology. Outcomes were examined via segmented linear regression using mixed effects models. The main data source was a population-based electronic health record. Results: 44,405 consecutive admissions (38,400 unique patients) admitted to 15 general medical/surgical and/or neurologic adult ICUs between 2014 and 2019 were included. The proportion of delirium days per ICU increased from 30.24% to 35.31% during the pre-intervention period. After intervention implementation it decreased significantly (bimonthly decrease of 0.34%, 95%CI 0.18-0.50%, p < 0.01) from 33.48% (95%CI 29.64-37.31%) in 2017 to 28.74% (95%CI 25.22-32.26%) in 2019. The proportion of sedation days using midazolam demonstrated an immediate decrease of 7.58% (95%CI 4.00-11.16%). There were no significant changes in duration of invasive ventilation, proportion of partial coma days, ICU mortality, or potential adverse events. Conclusions: An ABCDEF delirium initiative was implemented on a population-basis within adult ICUs and was successful at reducing the prevalence of delirium. |
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| MeSH term(s) | Adult ; Humans ; Alberta/epidemiology ; Critical Care ; Delirium/epidemiology ; Delirium/prevention & control ; Intensive Care Units ; Interrupted Time Series Analysis ; Quality Improvement | |||||
| Language | English | |||||
| Publishing date | 2024-01-10 | |||||
| Publishing country | United States | |||||
| Document type | Clinical Trial ; Journal Article ; Multicenter Study | |||||
| ZDB-ID | 632818-0 | |||||
| ISSN | 1557-8615 ; 0883-9441 | |||||
| ISSN (online) | 1557-8615 | |||||
| ISSN | 0883-9441 | |||||
| DOI | 10.1016/j.jcrc.2024.154524 | |||||
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| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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