{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T08:14:31Z","timestamp":1788336871625,"version":"build-2803163510"},"reference-count":39,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T00:00:00Z","timestamp":1713225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["K08HS024552"],"award-info":[{"award-number":["K08HS024552"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012375","name":"School of Nursing, University of Washington","doi-asserted-by":"publisher","award":["Donor Funding"],"award-info":[{"award-number":["Donor Funding"]}],"id":[{"id":"10.13039\/100012375","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100012400","name":"Sigma Theta Tau International","doi-asserted-by":"publisher","award":["Rho Chapter Grant"],"award-info":[{"award-number":["Rho Chapter Grant"]}],"id":[{"id":"10.13039\/100012400","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The Awakening, Breathing Coordination, Delirium monitoring and Early mobility bundle (ABCDE) is associated with lower mortality for intensive care unit (ICU) patients. However, efforts to improve ABCDE are variably successful, possibly due to lack of clarity about who are the team members interacting when caring for each patient, each shift. Lack of patient shift-level information regarding who is interacting with whom limits the ability to tailor interventions to the specific ICU team to improve ABCDE.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Determine the number and types of individuals (i.e., clinicians and family members) interacting in the care of mechanically ventilated (MV) patients, as reported by the patients\u2019 assigned physician, nurse, and respiratory therapist (RT) each shift, using a network science lens.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We conducted a prospective, patient-shift-level survey in 2 medical ICUs. For each patient, we surveyed the assigned physician, nurse, and RT each day and night shift about who they interacted with when providing ABCDE for each patient-shift. We determined the number and types of interactions, reported by physicians, nurses, and RTs and day versus night shift.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>From 1558 surveys from 404 clinicians who cared for 169 patients over 166 shifts (65% response rate), clinicians reported interacting with 2.6 individuals each shift (physicians: 2.65, nurses: 3.33, RTs: 1.86); this was fewer on night shift compared to day shift (1.99 versus 3.02). Most frequent interactions were with the bedside nurse, attending, resident, intern, and RT; family member interactions were reported in less than 1 in 5 surveys (12.2% of physician surveys, 19.7% of nurse surveys, 4.9% of RT surveys).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Interpretation<\/jats:title>\n<jats:p>Clinicians reported interacting with 3\u20134 clinicians each shift, and fewer on nights. Nurses interacted with the most clincians and family members. Interventions targeting shift-level teams, focusing on nurses and family members, may be a way to improve ABCDE delivery and ICU teamwork.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0298586","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T17:44:28Z","timestamp":1713289468000},"page":"e0298586","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Patterns of interactions among ICU interprofessional teams: A prospective patient-shift-level survey approach"],"prefix":"10.1371","volume":"19","author":[{"given":"Hannah C.","family":"Ratliff","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Yakusheva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily M.","family":"Boltey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deanna J.","family":"Marriott","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-5349","authenticated-orcid":true,"given":"Deena Kelly","family":"Costa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"issue":"5","key":"pone.0298586.ref001","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1097\/CCM.0000000000000129","article-title":"Effectiveness and safety of the awakening and breathing coordination, delirium monitoring\/management, and early exercise\/mobility bundle","volume":"42","author":"MC Balas","year":"2014","journal-title":"Critical care medicine"},{"issue":"9","key":"pone.0298586.ref002","doi-asserted-by":"crossref","first-page":"e825","DOI":"10.1097\/CCM.0000000000003299","article-title":"Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation\/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU","volume":"46","author":"JW Devlin","year":"2018","journal-title":"Critical Care Medicine"},{"issue":"9607","key":"pone.0298586.ref003","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/S0140-6736(08)60105-1","article-title":"Efficacy and safety of a paired sedation and ventilator weaning protocol for mechanically ventilated patients in intensive care (Awakening and Breathing Controlled trial): a randomised controlled trial","volume":"371","author":"TD Girard","year":"2008","journal-title":"The Lancet"},{"issue":"1","key":"pone.0298586.ref004","doi-asserted-by":"crossref","first-page":"54","DOI":"10.4037\/ajcc2022768","article-title":"Effects of a National Quality Improvement Collaborative on ABCDEF Bundle Implementation","volume":"31","author":"MC Balas","year":"2022","journal-title":"American Journal of Critical Care"},{"issue":"6","key":"pone.0298586.ref005","doi-asserted-by":"crossref","first-page":"A201","DOI":"10.1016\/j.chest.2021.12.233","article-title":"Effects of the COVID-19 pandemic on sedation practices and the ABCDEF bundle compliance: A national survey of intensivists in the United States","volume":"161","author":"A Braun","year":"2022","journal-title":"Chest"},{"issue":"1","key":"pone.0298586.ref006","doi-asserted-by":"crossref","first-page":"101","DOI":"10.4187\/respcare.09925","article-title":"Group on behalf of the ES. 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