The ICU liberation project benefits patients and families by adhering to Parkland's Mission and the CIRCLES of life.
Compassion: ICU liberation promotes doing what's best for the patients versus what's historically been done or what is easier. ICU liberation A-F bundles utilized evidence-based processes to prevent delirium and ensure more positive functional outcomes in ICU patients. Research shows that many things we historically have done, such as the use of sedatives, keeping the lights off, and keeping patients in bed can cause damage to our patients physically and mentally. As the bundle champions incorporated best practices such as decreasing the use of Benzodiazepines, turning room lights on and raising the shades at 7:00 am, and mobilizing patients, the patient's risk of developing ICU delirium decreased. The bundle champions volunteered to serve on a specific bundle because they truly care about not only the care the patient receives while in the unit but ensuring the patient does not have a decreased quality of life post-ICU discharge.
Integrity: Transparent communication with patients and families about the plan of care has increased with better visibility from the providers (bedside rounding) and family communication coaching as taught by the family bundle.
Respect: The standardization of nursing practice in the SICU, including assessing for pain, agitation, delirium, and performing SAT/SBT on all patients, give each patient an equal chance at the best outcomes.
Collaboration: The Early Mobility bundle incorporated members from PT, OT, RT, providers, and nursing to promote out of bed mobility to prevent ICU delirium and the physical deterioration associated with prolonged bed rest. As a part of ICU liberation, providers round at the bedside, each stopping the conversation to ask the bedside nurse about pain, agitation, delirium, and mobility. The SICU NP's were instrumental in introducing the bundle elements to new SICU providers each month.
Leadership: Bundle champions held their peers accountable to the standards of each bundle. For example, when a bundle champion noted that their peers did not have the lights on and shades up in the patient room, they would talk to their peer and help them understand the importance of this action in decreasing delirium. Another example is when the Early Mobility champions would take the vented patients in order for staff to see them walking with PT/OT and the patient, leading by example.
Excellence: The staff-nurse-led approach adopted for ABCDEF bundle implementation in the Parkland SICU has led to the implementation of eight evidence-based-practice projects over seven months.
Stewardship: By shortening lengths of stay and ventilator days, patient and facility costs are reduced.
Three doctors brought the project to the SICU and requested volunteers to champion each part of the A-F bundles. Each of the bundles was made up of frontline nursing staff who put forth the effort to educate staff and create tools to help ICU liberation come to fruition.
With the ICU liberation team, a retrospective comparison between the 6 months prior to a full rollout of ICU liberation versus 6 months after showed a decrease in average ICU days from 4.2 to 2.5, a decrease in average mechanical ventilation hours from 107.1 to 56.6 hours, a 40% reduction of benzodiazepine use, and a decrease in average hospital lengths of stay from 17 to 15 days.

DAISY Team Award Honorees:
Farhennaz Ajani, RN
Ashely Bahena, RN
Christina Babayan-Fard, RN
Karen Cordova, RN
Tina Damas, RN
Jennifer Davis, RN
Kelly Dorsey, RN
Mirella Espinoza, RN
Caroline Gachuiri, RN
Connor Geiger, RN
Paige Golden, RN
Lia Lacuone, RN
Jacquelyn Jackson, RN
Elizabeth Jobson, RN
Elana Levy, RN
Kim Mai, RN
Anne Marie Martin, RN
Shontell Moore, RN
Lee Penix, RN
Keslie Satterwhite, RN
Kristi Snow, RN
Ashleigh Stevens, RN
Dustie Trigona, RN
Jessica Whitis, RN