{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T00:57:21Z","timestamp":1792112241402,"version":"4.4.0"},"reference-count":26,"publisher":"AACN Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"Background<\/jats:title>Nurse-led rounding checklists are a common strategy for facilitating evidence-based practice in the intensive care unit (ICU). To streamline checklist workflow, some ICUs have the nurse or another individual listen to the conversation and customize the checklist for each patient. Such customizations assume that individuals can reliably assess whether checklist items have been addressed.<\/jats:p><\/jats:sec>Objective<\/jats:title>To evaluate whether 1 critical care nurse can reliably assess checklist items on rounds.<\/jats:p><\/jats:sec>Methods<\/jats:title>Two nurses performed in-person observation of multidisciplinary ICU rounds. Using a standardized paper-based assessment tool, each nurse indicated whether 17 items related to the ABCDEF bundle were discussed during rounds. For each item, generalizability coefficients were used as a measure of reliability, with a single-rater value of 0.70 or greater considered sufficient to support its assessment by 1 nurse.<\/jats:p><\/jats:sec>Results<\/jats:title>The nurse observers assessed 118 patient discussions across 15 observation days. For 11 of 17 items (65%), the generalizability coefficient for a single rater met or exceeded the 0.70 threshold. The generalizability coefficients (95% CIs) of a single rater for key items were as follows: pain, 0.86 (0.74-0.97); delirium score, 0.74 (0.64-0.83); agitation score, 0.72 (0.33-1.00); spontaneous awakening trial, 0.67 (0.49-0.83); spontaneous breathing trial, 0.80 (0.70-0.89); mobility, 0.79 (0.69-0.87); and family (future\/past) engagement, 0.82 (0.73-0.90).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Using a paper-based assessment tool, a single trained critical care nurse can reliably assess the discussion of elements of the ABCDEF bundle during multidisciplinary rounds.<\/jats:p><\/jats:sec>","DOI":"10.4037\/ajcc2023755","type":"journal-article","created":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T03:10:50Z","timestamp":1677640250000},"page":"92-99","source":"Crossref","is-referenced-by-count":4,"title":["Measuring Performance on the ABCDEF Bundle During Interprofessional Rounds via a Nurse-Based Assessment Tool"],"prefix":"10.4037","volume":"32","author":[{"given":"Andrew J.","family":"King","sequence":"first","affiliation":[{"name":"Andrew J. King is a research assistant professor in the Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly M.","family":"Potter","sequence":"additional","affiliation":[{"name":"Kelly M. Potter is a postdoctoral fellow in the Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer B.","family":"Seaman","sequence":"additional","affiliation":[{"name":"Jennifer B. Seaman is an assistant professor in the Department of Acute and Tertiary Care, University of Pittsburgh School of Nursing."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Chiyka","sequence":"additional","affiliation":[{"name":"Elizabeth A. Chiyka is a graduate student in the Department of Human Genetics, University of Pittsburgh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany A.","family":"Hileman","sequence":"additional","affiliation":[{"name":"Bethany A. Hileman is an undergraduate student in the Department of Molecular Biology, University of Pittsburgh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory F.","family":"Cooper","sequence":"additional","affiliation":[{"name":"Gregory F. Cooper is a professor in the Department of Biomedical Informatics, University of Pittsburgh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle L.","family":"Mowery","sequence":"additional","affiliation":[{"name":"Danielle L. Mowery is an assistant professor in the Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek C.","family":"Angus","sequence":"additional","affiliation":[{"name":"Derek C. Angus is a professor in the Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Kahn","sequence":"additional","affiliation":[{"name":"Jeremy M. Kahn is professor in the Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2471","reference":[{"issue":"8","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"1015","DOI":"10.1164\/rccm.201608-1690ST","article-title":"An official American Thoracic Society research statement: implementation science in pulmonary, critical care, and sleep medicine","volume":"194","author":"Weiss","year":"2016","journal-title":"Am J Respir Crit Care Med"},{"issue":"1","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1186\/s13054-015-0886-9","article-title":"A systematic review of implementation strategies for assessment, prevention, and management of ICU delirium and their effect on clinical outcomes","volume":"19","author":"Trogrli\u0107","year":"2015","journal-title":"Crit Care"},{"issue":"2","key":"2023030103104512600_","first-page":"183","article-title":"Development and implementation of an ICU quality improvement checklist","volume":"18","author":"Simpson","year":"2007","journal-title":"AACN Adv Crit Care"},{"issue":"5","key":"2023030103104512600_","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 (ABCDE) bundle","volume":"42","author":"Balas","year":"2014","journal-title":"Crit Care Med"},{"issue":"2","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1097\/CCM.0000000000002149","article-title":"Improving hospital survival and reducing brain dysfunction at seven California community hospitals: implementing PAD guidelines via the ABCDEF bundle in 6,064 patients","volume":"45","author":"Barnes-Daly","year":"2017","journal-title":"Crit Care Med"},{"issue":"10","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1136\/bmjqs-2017-007218","article-title":"Perceptions of rounding checklists in the intensive care unit: a qualitative study","volume":"27","author":"Hallam","year":"2018","journal-title":"BMJ Qual Saf"},{"issue":"10","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1097\/PCC.0000000000002733","article-title":"eSIMPLER: a dynamic, electronic health record-integrated checklist for clinical decision support during PICU daily rounds","volume":"22","author":"Geva","year":"2021","journal-title":"Pediatr Crit Care Med"},{"issue":"2","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1016\/j.bja.2020.09.044","article-title":"Intelligent checklists improve checklist compliance in the intensive care unit: a prospective before-and-after mixed-method study","volume":"126","author":"De Bie","year":"2021","journal-title":"Br J Anaesth"},{"issue":"6","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1164\/rccm.201101-0037OC","article-title":"Prompting physicians to address a daily checklist and process of care and clinical outcomes: a single-site study","volume":"184","author":"Weiss","year":"2011","journal-title":"Am J Respir Crit Care Med"},{"issue":"11","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"2563","DOI":"10.1097\/CCM.0b013e318298291a","article-title":"A clinical trial comparing physician prompting with an unprompted automated electronic checklist to reduce empirical antibiotic utilization","volume":"41","author":"Weiss","year":"2013","journal-title":"Crit Care Med"},{"issue":"5","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1097\/MCC.0b013e328364d538","article-title":"Prompting physicians to address a daily checklist for antibiotics: do we need a co-pilot in the ICU?","volume":"19","author":"Weiss","year":"2013","journal-title":"Curr Opin Crit Care"},{"issue":"2","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/CCM.0000000000002175","article-title":"The ABCDEF bundle: science and philosophy of how ICU liberation serves patients and families","volume":"45","author":"Ely","year":"2017","journal-title":"Crit Care Med"},{"issue":"4","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"562","DOI":"10.1097\/CCM.0000000000004197","article-title":"Best practices for conducting interprofessional team rounds to facilitate performance of the ICU Liberation (ABCDEF) Bundle","volume":"48","author":"Stollings","year":"2020","journal-title":"Crit Care Med"},{"issue":"6","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1037\/0003-066X.44.6.922","article-title":"Generalizability theory","volume":"44","author":"Shavelson","year":"1989","journal-title":"Am Psychol"},{"issue":"2","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1016\/j.ccc.2016.12.005","article-title":"The ABCDEF bundle in critical care","volume":"33","author":"Marra","year":"2017","journal-title":"Crit Care Clin"},{"issue":"10","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1097\/00003246-200110000-00026","article-title":"Critical care delivery in the intensive care unit: defining clinical roles and the best practice model","volume":"29","author":"Brilli","year":"2001","journal-title":"Crit Care Med"},{"issue":"6","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"980","DOI":"10.1097\/CCM.0000000000003067","article-title":"Interprofessional care and teamwork in the ICU","volume":"46","author":"Donovan","year":"2018","journal-title":"Crit Care Med"},{"issue":"2","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1136\/jamia.1999.0060143","article-title":"A reliability study for evaluating information extraction from radiology reports","volume":"6","author":"Hripcsak","year":"1999","journal-title":"J Am Med Inform Assoc"},{"issue":"6","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1136\/jamia.2000.0070593","article-title":"Automatic detection of acute bacterial pneumonia from chest X-ray reports","volume":"7","author":"Fiszman","year":"2000","journal-title":"J Am Med Inform Assoc"},{"issue":"5","key":"2023030103104512600_","first-page":"360","article-title":"Understanding interobserver agreement: the kappa statistic","volume":"37","author":"Viera","year":"2005","journal-title":"Fam Med"},{"key":"2023030103104512600_","unstructured":"R Core Team . R: a language and environment for statistical computing. R Foundation for Statistical Computing. 2020. Accessed September 1, 2022. https:\/\/www.r-project.org\/"},{"issue":"4","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1177\/00131644211033899","article-title":"A Monte Carlo study of confidence interval methods for generalizability coefficient","volume":"82","author":"Jiang","year":"2022","journal-title":"Educ Psychol Meas"},{"issue":"14","key":"2023030103104512600_","doi-asserted-by":"crossref","first-page":"1480","DOI":"10.1001\/jama.2016.3463","article-title":"Effect of a quality improvement intervention with daily round checklists, goal setting, and clinician prompting on mortality of critically ill patients: a randomized clinical trial","volume":"315","author":"Cavalcanti","year":"2016","journal-title":"JAMA"},{"key":"2023030103104512600_","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1186\/s13012-014-0190-0","article-title":"A cluster randomized trial of a multifaceted quality improvement intervention in Brazilian intensive care units: study protocol","volume":"10","author":"Cavalcanti","year":"2015","journal-title":"Implement Sci"},{"issue":"6","key":"2023030103104512600_","first-page":"555","article-title":"The Rhode Island ICU Collaborative: a model for reducing central line-associated bloodstream infection and ventilator-associated pneumonia statewide","volume":"19","author":"DePalo","year":"2010","journal-title":"Qual Saf Health Care"},{"issue":"4","key":"2023030103104512600_","first-page":"855","article-title":"Measurable outcomes of quality improvement using a daily quality rounds checklist: one-year analysis in a trauma intensive care unit with sustained ventilator-associated pneumonia reduction","volume":"69","author":"Dubose","year":"2010","journal-title":"J Trauma"}],"container-title":["American Journal of Critical Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/32\/2\/92\/147973\/92.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article-pdf\/32\/2\/92\/147973\/92.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,26]],"date-time":"2023-03-26T22:29:57Z","timestamp":1679869797000},"score":1,"resource":{"primary":{"URL":"https:\/\/aacnjournals.org\/ajcconline\/article\/32\/2\/92\/31985\/Measuring-Performance-on-the-ABCDEF-Bundle-During"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,1]]},"references-count":26,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2023,3,1]]}},"URL":"https:\/\/doi.org\/10.4037\/ajcc2023755","relation":{},"ISSN":["1062-3264","1937-710X"],"issn-type":[{"value":"1062-3264","type":"print"},{"value":"1937-710X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,1]]}}}