The ICU Liberation Bundle was initially implemented in Kaiser Permanente Santa Rosa ICU in 2021. However, as with all protocols, maintaining up-to-date best practices requires consistent updates and reeducation. This ensures that nurses and other disciplines continue to provide the highest standard of care aligned with current evidence-based guidelines.
In March 2024, planning began under the leadership of Anna Gappi BSN, RN and Christina Andrade RN, MS, APRN-CNS, CNRN to host the SCCM NorCal Chapter’s ICU Liberation Bundle Course at KP SRO. This initiative aimed to provide a local venue for our team to access this valuable training. Our certified instructors from KP SRO were set to facilitate the course alongside SCCM lead instructors. The event was scheduled for October 24–25, but unfortunately, the course was cancelled due to insufficient participant registration.
In response, Gappi and Andrade pivoted to develop an ICU Liberation Bundle Workshop, tailored specifically for the KP SRO ICU team. This workshop was held on December 11, 2024, as a 4-hour course approved for BRN Continuing Education Units (CEUs). It was offered to staff from the ICU, Respiratory Therapy (RT), and Rehabilitation (Rehab) departments.
The workshop was made possible by the expertise of the KP SRO SCCM-certified instructors, including:
- Anna Gappi, BSN, RN
- Christina Andrade, RN, MS, APRN-CNS, CNRN
- Caroline Nganga, RT
- Joan Cosper, OT
- Chelsea Whitaker, PT
- Elizabeth Au, MD, Intensivist
Workshop Goals:
- Understand the ICU Liberation Bundle: Review its components and their importance in patient outcomes.
- Assess Current Implementation: Highlight effective practices and identify areas needing improvement.
- Promote Patient and Family-Centered Care: Emphasize strategies to improve engagement and support.
The KP SRO ICU team tracks the success of the ICU Liberation Bundle implementation through the following measures:
- SAT/SBT (Spontaneous Awakening Trial/Spontaneous Breathing Trial) Compliance
- Lung Protective Ventilation
- CAM-ICU (Confusion Assessment Method for ICU) Compliance
- ICU-Specific Mobilization
- Mean Days on Ventilator
- ICU Length of Stay
- ICU Mortality
This nurse-led workshop will now be offered annually to sustain our efforts in liberating patients from Post-Intensive Care Syndrome and fostering continuous improvement in ICU care delivery.
One of the most significant outcomes of this work has been the sustained reduction in ICU Length of Stay (LOS), which consistently remains under the goal. This achievement underscores the impact of the ICU Liberation Bundle in driving high-quality, efficient care in the ICU.