Effectiveness of a modified ABCDE bundle on ICU psychosis among cardiac postoperative patients at a selected tertiary care hospital, Coimbatore

Abstract

Background: Intensive care unit (ICU) delirium is a common postoperative complication among cardiac surgery patients and is associated with prolonged mechanical ventilation, increased hospital stays, higher healthcare costs, and poor clinical outcomes. Evidence regarding modified ABCDE bundle interventions specifically designed for cardiac postoperative patients remains limited. This study evaluated the effectiveness of a modified ABCDE bundle in reducing ICU delirium among adult cardiac postoperative patients. Methods: A true experimental, pretest-posttest control group design study was conducted among 30 adult cardiac postoperative patients admitted to the Cardio-Thoracic Intensive Care Unit of a tertiary care hospital in Coimbatore, Tamil Nadu. Participants were allocated into an intervention group (n=15), which received the modified ABCDE bundle in addition to routine care, and a routine care group (n=15). ICU delirium was assessed using the Intensive Care Delirium Screening Checklist (ICDSC). Descriptive statistics and paired and unpaired t tests were used for data analysis. Results: Baseline characteristics were comparable between groups. Post-intervention, the intervention group demonstrated significantly lower mean ICDSC scores than the routine care group (1.20±1.469 vs. 5.33±2.809). The intervention group also showed a greater reduction in delirium severity following implementation of the modified ABCDE bundle. Conclusions: The modified ABCDE bundle was effective in reducing ICU delirium among adult cardiac postoperative patients and may be incorporated into routine nurse-led postoperative ICU care to improve patient outcomes.