Date of Award
DNP Project Restricted
Doctor of Nursing Practice (DNP)
Cheryl Monturo, Ph.D., MBE, ACNP-BC
Daniel Salerno, M.D.
Background: Early extubation trials, sedation/pain management, and early mobility can reduce the length of stay and improve patient outcomes in patients undergoing coronary artery bypass graft (CABG) surgery.
Purpose: The purpose of this project was to implement the ABCDE Bundle in the Cardiac Intensive Care Unit (CICU). The goal was to reduce the intubation times of postoperative (CABG) patients after arriving at the CICU and to examine the length of stay, mobility and pain management levels of the groups.
Methods: This project used a retrospective chart review to examine coronary artery bypass graft (CABG) patient data eight weeks before and six weeks after a staff educational intervention on the ABCDE Bundle.
Results: A total of 11 patients were included in the pre-implementation and 22 in the post-implementation groups. Using the Mann-Whitney test no significant difference (p= 0.744) was evident between intubation times of both groups. Similarly, no significant difference was evident in the length of stay, (p=0.615).
Sedation management results varied based on RASS scores averaging 0.5 mcg/kg/hr for the pre-group and 0.7 mcg/kg/hr for the post group. Early mobility results showed a mean time of 14 hours and 41 minutes for the post group versus 52 hours and 21 minutes for the pre-group.
Conclusion/Implication for Practice: This project reported variable results. Given more time and a larger patient sample size, future projects may show significant improvements in the ABCDE Bundle variables consistent with evidence-based practice.
Bembry-Weiser, Cynthia, "The ABCDE Bundle : A QI Tool to Reduce the ICU Stay" (2019). West Chester University Doctoral Projects. 43.