Dissertation
From Surviving to Thriving: Implementing the Society of Critical Care Medicine's ICU Liberation Bundle
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2025
Abstract
Background The intensive care unit (ICU) is an independent risk factor for long-term, life-altering deficits known as post-intensive care syndrome (PICS). PICS includes cognitive impairment, physical dysfunction, and psychological distress, all of which diminish survivors quality of life and increase healthcare costs. Recognizing the need to mitigate these outcomes, the Society of Critical Care Medicine (SCCM) developed the ICU Liberation Bundle (ABCDEF), an evidence-based clinical practice guideline targeting modifiable risk factors such as pain, agitation, delirium, immobility, and sleep disruption.PurposeThis project aims to determine whether standardized implementation of the SCCM ICU liberation bundle reduces ICU length of stay, time on mechanical ventilation, and instances of delirium. MethodsThis evidence-based practice project implemented five components of the ICU Liberation Bundle at a 20-bed, mixed medical-surgical ICU using the Plan-Do-Study-Act (PDSA) model. Interventions included staff education, EMR template updates, interdepartmental collaboration, and developing a new nurse progress note template. Three outcome measures ICU length of stay, mechanical ventilation duration, and CAM-ICU positive assessments were compared pre- and post-implementation.FindingsWhile the project did not replicate national data trends in reduced ICU length of stay or mechanical ventilation time, it revealed statistically significant increases in CAM-ICU assessment frequency and documentation completeness. DiscussionDespite increased delirium screenings, findings were not statistically significant. Data skewness and kurtosis indicated heavy outliers and non-normal distribution, complicating analysis. Sustainability measures included: EMR changes, continued nurse education, and the development of a Critical Care Council to champion bundle elements. Limitations included a small sample size, implementation delays, and exclusion of family engagement. This project successfully laid a foundation for long-term, nurse-led integration of SCCM s ICU Liberation Bundle, reinforcing the value of structured, interdisciplinary care in improving post-ICU outcomes.
Details
- Title: Subtitle
- From Surviving to Thriving: Implementing the Society of Critical Care Medicine's ICU Liberation Bundle
- Creators
- Katie Stallman - University of Iowa
- Contributors
- Julie Stanik-Hutt (Chair) - University of Iowa
- Resource Type
- Dissertation
- Project Type
- Poster
- Degree Awarded
- Doctor of Nursing Practice (DNP), University of Iowa
- Degree in
- Adult/Gerontology Nurse Practitioner (Acute Care)
- Date degree season
- Spring 2025
- Publisher
- University of Iowa
- Number of pages
- 1 page
- Copyright
- Copyright 2025 Katie Stallman
- Language
- English
- Academic Unit
- College of Nursing; Doctor of Nursing Practice Projects
- Record Identifier
- 9984841036902771
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