{"id":116097,"date":"2024-10-18T02:00:00","date_gmt":"2024-10-18T07:00:00","guid":{"rendered":"https:\/\/www.unmc.edu\/newsroom\/?p=116097"},"modified":"2024-10-17T15:40:31","modified_gmt":"2024-10-17T20:40:31","slug":"landmark-unmc-research-studies-abcs-of-icu-care","status":"publish","type":"post","link":"https:\/\/www.unmc.edu\/newsroom\/2024\/10\/18\/landmark-unmc-research-studies-abcs-of-icu-care\/","title":{"rendered":"Landmark UNMC research studies ABC’s of ICU care"},"content":{"rendered":"
\n

Registered nurse Michele Balas, PhD, knows firsthand \u2013 and research has shown \u2013 that ICU patients fare better when health care teams implement evidence-based interventions every day.<\/p>\n\n\n\n

These basic interventions range from assessing the patient\u2019s pain to interrupting the use of sedation to increasing their mobility.<\/p>\n\n\n\n

Now \u2013 in a landmark study for UNMC \u2013 Dr. Balas leads the med center\u2019s first multisite, PCORnet\u00ae Study to assess strategies on how best to implement these evidence-based practices, known as the ABCDEF Bundle.<\/p>\n\n\n\n

\u201cThe ABCDEF Bundle is considered the standard of care and should be given to every <\/em>single patient, every <\/em>single day in the ICU whether or not they are on the ventilator,\u201d said Dr. Balas, associate dean of research and the Dorothy Hodges Olson Distinguished Professor of Nursing in the UNMC College of Nursing.<\/p>\n\n\n\n

Still, amid workforce shortages, the longtime ICU nurse knows that doesn\u2019t always happen \u2013 even among hospital systems and care teams with the best intentions.<\/p>\n\n\n\n

She also knows one of the most common complications among hospitalized older adults is delirium. In the past, she said, delirium or acute confusion has been dismissed as being normal or age-related, but \u201cwe now know a single episode of acute confusion in the hospital elevates your risk for long-term cognitive impairment that can be as severe as dementia or traumatic brain injury. It\u2019s not a single event.\u201d<\/p>\n\n\n\n

The good news, she said, is the interventions that make up the ABCDEF Bundle have proven effective in optimizing an ICU patient\u2019s recovery and outcomes, and she\u2019s determined to prove how best to implement the bundle on a broad scale.<\/p>\n\n\n\n

Funded by the National Institutes of Health\u2019s National Heart Lung Blood Institute and the National Institute of Nursing Research, Dr. Balas is leading a five-year study that involves mechanically ventilated ICU patients at Nebraska Medicine, The Ohio State University Wexner Medical Center and the University of Iowa Hospitals and Clinics.<\/p>\n\n\n\n

Out of 12 participating ICUs, six units will implement and track implementation of the bundle on every patient via an electronic dashboard. (Green indicates the lifesaving intervention already was done that day; yellow means there\u2019s still time to make it happen; red means it did not get done.) Meanwhile, six other ICUs will have one extra registered day nurse assigned to the ICU to \u201chelp in anyway needed to make the bundle come to life,\u201d Dr. Balas said.<\/p>\n\n\n\n

ICU data will be collected until early 2027 and then analyzed to determine what method works best to get evidence-based research \u2013 in this case the effective but underutilized ABCDEF Bundle \u2013 more quickly into clinical practice.<\/p>\n\n\n\n

\u201cWe\u2019re collecting so much data,\u201d Dr. Balas said. \u201cAnd I know we couldn\u2019t do the study without the resources available through the PCORnet ecosystem.\u201d<\/p>\n\n\n\n

The med center\u2019s involvement with national networks and ability to serve as a data coordinating center is notable, said Carol Geary, PhD, assistant professor in pathology\/microbiology and UNMC PCORnet principal investigator, and \u201cshows that UNMC is capable of playing in the research big leagues.\u201d<\/p>\n\n\n\n

She encourages other UNMC researchers to pursue clinical studies large enough to answer questions that can improve patient-centered outcomes. \u201cWe want people to say, \u2018I could do that too.\u2019\u201d<\/p>\n\n\n\n

The PCORnet\u00ae Study-designation denotes the study is powered by PCORnet, the National Patient-Centered Clinical Research Network, which is designed to improve the nation\u2019s capacity to conduct health research and has been developed with funding from the Patient-Centered Outcomes Research Institute.<\/p>\n\n\n\n

According to Dr. Geary, the study is an example of implementation science. \u201cThis is an important study for UNMC, the college of nursing and patient care and can help move evidence-based research into routine health care,\u201d she said.<\/p>\n\n\n\n

It\u2019s also a continuation of earlier UNMC and Nebraska Medicine studies, Dr. Balas said, that led to the ABCDEF Bundle becoming the standard of care. \u201cIf you have a loved one who is in the ICU \u2013 in any hospital, in any country \u2013 you should expect that they get the ABCDEF Bundle. It is considered standard of care and what every patient should get.\u201d<\/p>\n\n\n\n

And Dr. Balas expects her latest study to inform hospital systems and health care teams on how best to make that happen each day. \u201cI\u2019m in it to improve patient care and patient-centered outcomes,\u201d she said.<\/p>\n<\/div><\/div>","protected":false},"excerpt":{"rendered":"

The research, led by Michele Balas, PhD, is the med center\u2019s first multisite study through the National Patient-Centered Clinical Research 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