The impact of multidisciplinary collaborative bundled care on analgesia and sedation in ICU patients with endotracheal intubation

Abstract

Background: Effective analgesia and sedation management play a crucial role in reducing the intensity of coughing in patients with endotracheal intubation and improving clinical outcomes. However, current approaches are predominantly singular and lack comprehensive management strategies based on multidisciplinary collaboration. This study aims to evaluate the impact of multidisciplinary collaborative bundled care on analgesia and sedation in intensive care unit (ICU) patients with endotracheal intubation, providing evidence to inform clinical practice. Methods: Seventy ICU patients were enrolled with endotracheal intubation, admitted between January and August 2024. They were divided into a control group (n = 35) receiving routine care (admitted from January to April) and an intervention group (n = 35) receiving multidisciplinary collaborative bundled care (admitted from May to August). Outcomes measured included physical restraint use, analgesic dosage, cough strength, delirium incidence, and duration of mechanical ventilation. Results: The intervention group had significantly lower doses of remifentanil (8.37 ± 1.50 mg) and midazolam (21.43 ± 3.74 mg) compared to the control group (9.92 ± 1.58 and 31.12 ± 7.89 mg; P < .05). The incidence of delirium was also lower in the intervention group (11.4%) than in the control group (31.4%; P < .05). Delirium onset was delayed in the intervention group (3.02 ± 1.05 days) compared to the control group (2.58 ± 0.79 days), and its duration was shorter (3.43 ± 1.74 vs 5.12 ± 1.89 days; P < .05). Additionally, physical restraints were significantly lower in the intervention group (22.9% vs 45.7%; P < .05). Cough strength was notably higher in the intervention group (4.74 ± 0.82 vs 3.36 ± 0.76; P < .05), and the duration of mechanical ventilation was reduced (4.77 ± 1.42 vs 5.92 ± 1.66 days; P < .05). Conclusion: Multidisciplinary collaborative bundled care improves sedation and analgesia outcomes in ICU patients with endotracheal intubation, reducing medication dosage, incidence of delirium, physical restraint use, and duration of mechanical ventilation while enhancing cough strength.