Abstract

Background: Intensive Care Units (ICUs) provide critical care for severely ill patients requiring sedation and mechanical ventilation, which can lead to adverse outcomes (Temesgen et al., 2021; Park & Lee, 2019). The ICU Liberation bundle, from the Society of Critical Care Medicine's guidelines, prioritizes Pain, Agitation/Sedation, Delirium, Immobility, and Sleep disruption (PADIS), collectively known as the ABCDEF bundle. This strategy seeks to enhance outcomes through pain management, Spontaneous Awakening Trials (SAT), Spontaneous Breathing Trials (SBT), delirium management, early mobility, and family involvement (Mart et al., 2021).

Aims: This study examined nurses' profiles, knowledge, and practices related to the ABCDEF bundle in ICUs, analyzing associations among these variables.

Method: A correlation study was conducted in a governmental hospital ICU in Jeddah, Saudi Arabia, involving registered nurses with at least one year of ICU experience. Participants were purposively sampled from 105 nurses. Data were analyzed using SPSS for descriptive and inferential statistics.

Material: A structured survey assessed nurses' knowledge and practices regarding the ABCDEF bundle, covering demographics (age, gender, nationality, education, experience), perceptions of knowledge, assessments via nine binary statements, and self-reported practices using a four-point Likert scale on 24 statements. Validity was confirmed through expert review, yielding a high Content Validity Index (CVI), and reliability was supported by a Cronbach’s Alpha of 0.875.

Results: The study included 79 nurses, mostly female, aged 26-30. Over half showed high knowledge of the ABCDEF bundle, particularly excelling in "Assess, prevent, and manage pain," while "Family engagement" was least practiced. Demographics did not significantly affect knowledge; however, bundle integration varied by nationality, age, and experience (p-values: 0.001, 0.004, 0.002). A positive correlation existed between knowledge and integration of the bundle into practices.

Conclusion: Findings underscore the need to standardize ICU practices and enhance family involvement through education. Effective integration of the ABCDEF bundle and mentorship for novice nurses are crucial. Healthcare policies should ensure adequate resources for consistent application. Future research must address barriers to implementation and strategies to enhance family participation, vital for optimizing patient- and family-centered care in ICUs.

Notes

References:

- Balas, M. C., Pun, B. T., Pasero, C., Engel, H. J., Perme, C., Esbrook, C. L., ... Stollings, J. L. (2019). Common challenges to effective ABCDEF bundle implementation: The ICU liberation campaign experience. Critical Care Nurse, 39(1), 46–60.

- Mart, M. F., Williams Roberson, S., Salas, B., Pandharipande, P. P., & Ely, E. W. (2021). Prevention and Management of Delirium in the Intensive Care Unit. Seminars in Respiratory and Critical Care Medicine, 42(1), 112–126.

- Park, S. Y., & Lee, H. B. (2019). Prevention and management of delirium in critically ill adult patients in the intensive care unit: A review based on the 2018 PADIS guidelines. Acute and Critical Care, 34(2) 117–125.

- Society of Critical Care Medicine. (n.d.). ICU Liberation Bundle (A-F). Retrieved from https://www.sccm.org/iculiberation/abcdef-bundles

- Temesgen, N., Chekol, B., Tamirie, T., Eshetie, D., Simeneh, N., & Feleke, A. (2021). Adult sedation and analgesia in a resource limited intensive care unit - A Systematic Review and evidence-based guideline. Annals of Medicine and Surgery, 66, 102356.

Description

This study evaluated nurses' knowledge and practice regarding ABCDEF bundle in a governmental hospital ICU in Saudi Arabia. Involving 79 nurses, utilized a structured survey to assess profile, knowledge, and practice.Results showed over half of nurses had high knowledge, with "pain management" most practiced and "family engagement" least.Notably, integration varied by nationality,age,and experience. Findings underscore the need for standardized practices and enhanced family involvement in ICU.

Author Details

Sahar S. Aljadani, MSN, RN; Hanan M. Alyami, PhD, RN

Sigma Membership

Alpha Beta Tau at-Large

Type

Poster

Format Type

Text-based Document

Study Design/Type

Descriptive/Correlational

Research Approach

Quantitative Research

Keywords:

Acute Care, Intensive Care Units, Critical Care Medicine, Critically Ill Patient Care, Health Outcome Assessment

Conference Name

37th International Nursing Research Congress

Conference Host

Sigma Theta Tau International

Conference Location

Toronto, Ontario, Canada

Conference Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2026-09-25

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Integrated Patient Care Practice in Intensive Care Unit Related to ABCDEF Bundle: A Correlation Study

Toronto, Ontario, Canada

Background: Intensive Care Units (ICUs) provide critical care for severely ill patients requiring sedation and mechanical ventilation, which can lead to adverse outcomes (Temesgen et al., 2021; Park & Lee, 2019). The ICU Liberation bundle, from the Society of Critical Care Medicine's guidelines, prioritizes Pain, Agitation/Sedation, Delirium, Immobility, and Sleep disruption (PADIS), collectively known as the ABCDEF bundle. This strategy seeks to enhance outcomes through pain management, Spontaneous Awakening Trials (SAT), Spontaneous Breathing Trials (SBT), delirium management, early mobility, and family involvement (Mart et al., 2021).

Aims: This study examined nurses' profiles, knowledge, and practices related to the ABCDEF bundle in ICUs, analyzing associations among these variables.

Method: A correlation study was conducted in a governmental hospital ICU in Jeddah, Saudi Arabia, involving registered nurses with at least one year of ICU experience. Participants were purposively sampled from 105 nurses. Data were analyzed using SPSS for descriptive and inferential statistics.

Material: A structured survey assessed nurses' knowledge and practices regarding the ABCDEF bundle, covering demographics (age, gender, nationality, education, experience), perceptions of knowledge, assessments via nine binary statements, and self-reported practices using a four-point Likert scale on 24 statements. Validity was confirmed through expert review, yielding a high Content Validity Index (CVI), and reliability was supported by a Cronbach’s Alpha of 0.875.

Results: The study included 79 nurses, mostly female, aged 26-30. Over half showed high knowledge of the ABCDEF bundle, particularly excelling in "Assess, prevent, and manage pain," while "Family engagement" was least practiced. Demographics did not significantly affect knowledge; however, bundle integration varied by nationality, age, and experience (p-values: 0.001, 0.004, 0.002). A positive correlation existed between knowledge and integration of the bundle into practices.

Conclusion: Findings underscore the need to standardize ICU practices and enhance family involvement through education. Effective integration of the ABCDEF bundle and mentorship for novice nurses are crucial. Healthcare policies should ensure adequate resources for consistent application. Future research must address barriers to implementation and strategies to enhance family participation, vital for optimizing patient- and family-centered care in ICUs.