{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T19:15:52Z","timestamp":1775157352287,"version":"3.50.1"},"reference-count":22,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T00:00:00Z","timestamp":1596672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006578","name":"Chi Mei Medical Center","doi-asserted-by":"publisher","award":["107CM\u2010KMU\u201004"],"award-info":[{"award-number":["107CM\u2010KMU\u201004"]}],"id":[{"id":"10.13039\/501100006578","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2021,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Prolonged physical immobilization has negative effects on patients on mechanical ventilation (MV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>To introduce a quality improvement programme with early mobilization on the outcomes of patients on MV in the intensive care unit (ICU). We particularly studied the impact of the ABCDE (daily <jats:bold>A<\/jats:bold>wakening, <jats:bold>B<\/jats:bold>reathing trial, drug <jats:bold>C<\/jats:bold>o\u2010ordination, <jats:bold>D<\/jats:bold>elirium survey and treatment, and <jats:bold>E<\/jats:bold>arly mobilization) bundle on the outcome of MV patients with acute respiratory failure in the ICU.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>This is a retrospective, observational, before\u2010and\u2010after outcome study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Adult patients on MV (N\u00a0=\u00a0173) admitted to a medical centre ICU with 19 beds in southern Taiwan were enrolled. A multidisciplinary team (critical care nurse, nursing assistant, respiratory therapist, physical therapist, patient's family) performed ABCDE with early mobilization within 72\u2009hours of MV when patients became haemodynamically stable (twice daily [30\u2009minutes each time], 5\u2009days\/week during family visits and in co\u2010operation with family members).<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>The main outcome measures were differences of MV duration, ICU and hospital length of stay, medical costs, and intra\u2010hospital mortality before (phase 1) and after (phase 2) bundle care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Phases 1 and 2 revealed several differences, including Acute Physiology and Chronic Health Evaluation (APACHE) II and blood urea nitrogen and creatinine levels. The patients in phase 2 had a significantly lower mean ICU length of stay (8.0 vs 12.0\u2009days) but a similar MV duration (170.2 vs 188.1\u2009hours), hospital stays (21.1 vs 23.3\u2009days) with reduced costs (22.1 vs 31.7\u2009\u00d7\u200910<jats:sup>4<\/jats:sup> NT$), and intra\u2010hospital mortality (8.3 vs. 36.6%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The ABCDE care bundle improved the outcome of acute renal failure patients with MV, especially shortening ICU stays and lowering medical costs and hospital mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to clinical practice<\/jats:title><jats:p>An ABCDE care bundle with an inter\u2010professional, evidence\u2010based, multicomponent ICU early mobilization management strategy can reduce ICU stays, hospital expenditure, and mortality among acute respiratory failure patients with MV.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nicc.12530","type":"journal-article","created":{"date-parts":[[2020,8,7]],"date-time":"2020-08-07T01:58:09Z","timestamp":1596765489000},"page":"380-385","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Outcome of improved care bundle in acute respiratory failure patients"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7183-0787","authenticated-orcid":false,"given":"Chin\u2010Ming","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Intensive Care Medicine Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ai\u2010Chin","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences Industry Chang Jung Christian University  Tainan Taiwan"},{"name":"Section of Respiratory Care, Department of Internal Medicine Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willy","family":"Chou","sequence":"additional","affiliation":[{"name":"Department of Recreation and Health\u2010Care Management Chia Nan University of Pharmacy and Science  Tainan Taiwan"},{"name":"Department of Physical Medicine and Rehabilitation Chiali, Chi Mei Medical Center  Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Padhmavathi","family":"Selvam","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Environmental Biology Kaohsiung Medical University  Kaohsiung Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8805-2758","authenticated-orcid":false,"given":"Chih Mei","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Environmental Biology Kaohsiung Medical University  Kaohsiung Taiwan"},{"name":"Department of Medical Research Kaohsiung Medical 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