Implementation Science

PICU Liberation (Pediatrics)

Concurrent Session Moderator(s)

• JZ

  Jerry Zimmerman, MD, PhD, FCCM

  Faculty, Pediatric Critical Care Medicine
  Seattle Children's Hospital
  Seattle, Washington

  Disclosure(s): Elsevier Publishing: Receipt of Royalties (Ongoing); Immunexpress, Seattle: Grants/Research Support Recipient (Ongoing); NIH/NICHD: Grants/Research Support Recipient (Ongoing)
• 

  Chani Traube, MD, FAAP, FCCM

  Pediatric Intensivist, Clinical Researcher
  NewYork Presbyterian Hospital
  New York, NY

  Disclosure(s): No relevant financial relationship(s) to disclose.

PICU Liberation reflects bundled clinical standard work for provision of usual care to critically ill patients. Implementation of the ICU Liberation Bundle (A-F) facilitates patients who are more awake and physically and psychosocially active. The ICU Liberation Bundle includes the following elements: A: assess, prevent, and manage pain; B: both daily (at least) spontaneous awakening and spontaneous breathing trials (proactively wean sedation and mechanical ventilation); C: choice of and need for sedatives (avoiding benzodiazepines and diphenhydramine); D: delirium (monitoring and modulating); E: early mobilization; and F: family engagement and empowerment. This approach emphasizes nonpharmacologic approaches to analgesia and anxiolysis, promotes weaning of therapies when appropriate, facilitates delirium detection and prevention, encourages patient activity of any kind, and encourages patients and families to be involved in the care plan as team members. In a dose-response fashion, ICU Liberation is strongly associated with improvements in multiple, patient-centered, clinically meaningful outcomes, including reduced mortality for both adults and children. Successful implementation of PICU Liberation requires multiprofessional commitment and use of quality improvement, dissemination, and change leadership tools to adapt the unit's strategy to unit-specific resources, personnel, and capabilities.

This is a designated Twitter session. Use the hashtag #ICULiberation and #PedsICUin your tweets. Get tips on live tweeting and more here.

Presentations:

• PICU Liberation: Evidence-Based Approach to Enhancing the Standard of Care
  

  Concurrent Session Faculty: Chani Traube, MD, FAAP, FCCM – NewYork Presbyterian Hospital
• ICU Liberation: The Early Days
  

  Concurrent Session Faculty: Jerry Zimmerman, MD, PhD, FCCM – Seattle Children's Hospital
• A Need for Change: The Current State of A-F in Pediatrics
  

  Concurrent Session Faculty: Sapna Kudchadkar, MD, PhD, FCCM – Johns Hopkins University School of Medicine
• Implementation of ABCs: A-C
  

  Concurrent Session Faculty: Kristina A. Betters, MD (she/her/hers) – Vanderbilt University
• Implementation of ABCs: D
  

  Concurrent Session Faculty: Debbie Long (she/her/hers) – University of Queensland
• Implementation of ABCs: E-F
  

  Concurrent Session Faculty: Brenda M. Morrow, PhD, (she/her/hers) – University of Cape Town
• Best Practices: Quality Improvement, Safety, and Sustainability
  

  Concurrent Session Faculty: Karen Choong, MB, BCh, FRCP(C) – McMaster Children's Hospital
• Putting It All Together: PICU Liberation in Action
  

  Concurrent Session Faculty: Chani Traube, MD, FAAP, FCCM – NewYork Presbyterian Hospital
• Network With Experts
  

  Concurrent Session Faculty: Jerry Zimmerman, MD, PhD, FCCM – Seattle Children's Hospital