ABCDE Bundle Huddle Script

Huddles are a great way to get out information to a large number of people. Huddles are designed to be informational and educational in nature, lasting just a few minutes. One effective huddle format is to gather staff of the oncoming shift prior to receiving report and assuming new assignments – and before they are too busy to leave the patient care area.

As you know, I just returned from AACN’s NTI conference in Orlando. I learned some great new information about the ABCDE Bundle. I’d like to share this information with you because I think it’s something that could help our patients.

Purpose: The ABCDE bundle is a group of evidence-based practices that help prevent some of the unintended consequences we see with our critically ill patients. It is a collaborative care model that involves respiratory therapists, physical therapists, pharmacists, physicians and nurses.

Components: There are three components to the ABCDE Bundle. ABC – Awakening and Breathing Trial Coordination – Oversedation and undersedation can lead to prolonged ventilator times for our patients. This “ABC” bundle component addresses daily Spontaneous Awakening Trials (sedation vacation) and Spontaneous Breathing Trials to promote earlier extubation. D – Delirium Assessment and Management – All of our patients are susceptible to developing delirium. Unfortunately, delirium often goes undetected and untreated in scores of patients, potentially leading to a host of negative long-term consequences. This “D” bundle component addresses early identification and management of patients with delirium. E – Early Exercise and Progressive Mobility – All patients with prolonged bedrest or immobility are prone to developing muscle weakness and atrophy, which can lead to a longer hospital stay and long-term muscle dysfunction. This “E” bundle component provides guidance for enabling patients to become progressively more active and, possibly, walk while intubated.

Results: Implementation of any one component of the ABCDE bundle will improve the outcomes for our patients. Specifically, benefits of the bundle include:  Decreased mortality  Decreased ventilator time  Decreased length of stay  Decreased delirium and long-term cognitive impairment  Decreased prolonged muscle weakness

What We Can Do: We should consider forming a team to oversee implementation of the ABCDE Bundle in our unit.