Bundles and Checklists

doi:10.1017/9781009501477.012

Chapter 11 - Bundles and Checklists

from Section 3 - Strategies to Prevent PICS

Published online by Cambridge University Press: 22 January 2026

Michael Baram and

Edited by

Brad W. Butcher: Affiliation:
University of Pittsburgh School of Medicine, Pennsylvania

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Summary

The Society of Critical Care Medicine (SCCM) launched the Intensive Care Unit (ICU) Liberation Campaign in 2014 as a project to improve patient- and family-centered care that packaged key concepts from 2013 and 2018 clinical practice guidelines into a six-element bundle delivered by an interprofessional team at the bedside. The goals of the bundle include: optimizing pain management, shortening the duration of mechanical ventilation, minimizing the use of sedating medications, and reducing the incidence and duration of delirium and ICU-acquired weakness, largely by keeping the patient as physically and cognitively engaged as possible through early mobilization and family engagement. In addition to these short-term goals, incorporation of the ABCDEF bundle is one major strategy to decrease the risk of PICS. The ABCDEF bundle includes: Assess, prevent, and manage pain, Both spontaneous awakening trials (SAT) and spontaneous breathing trials (SBT), Choice of analgesia and sedation, Delirium: assess, prevent, and manage, Early mobility and exercise, and Family engagement and empowerment. The bundle, whose elements are interdependent and synergistic, has demonstrated significant efficacy in improving several outcomes in critically ill patients, but compliance with the bundle is still suboptimal worldwide. Accordingly, many institutions utilize ‘checklists’ as cognitive aides to enhance bundle adherence with modest success.

Keywords

ABCDEF bundle bundle checklist compliance pain sedation delirium mobilization family engagement spontaneous awakening trial spontaneous breathing trial quality improvement

Information

Type: Chapter
Information: Post-Intensive Care Syndrome
A Practical Approach
, pp. 135 - 149
DOI: https://doi.org/10.1017/9781009501477.012 [Opens in a new window]
Publisher: Cambridge University Press
Print publication year: 2026

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