A-F mobility bundle
A patient is awake, grimacing, and pointing to their chest but has stable vital signs. Which A–F bundle element should be addressed first?
What is A – Assess, prevent, and manage pain?
A Passy-Muir Valve allows air to flow in through the trach but out through the _____.
What is the upper airway?
A RASS score of 0 indicates what patient state?
What is alert and calm?
What does HLM stand for?
What is Highest Level of Mobility?
During admission, a patient’s home medication list is incomplete and unclear. Which discipline should take the lead in clarifying medications?
What is pharmacy?
During rounds, a patient remains on continuous sedation with no contraindications to interruption. Which A–F bundle element should the team consider next?
What is B – Spontaneous awakening and breathing trials?
Which discipline typically evaluates speech and swallowing when a Passy-Muir Valve is in place?
What is Speech-Language Pathology (SLP)?
What RASS score range is generally targeted for light sedation in ICU patients?
What is -2 to 0?
A patient can sit on the side of the bed but requires assistance to stand. Which tool helps determine safe mobility progression?
A ventilated ICU patient is stable, lightly sedated, and ready to begin early mobility. Which two disciplines most commonly collaborate first to initiate movement?
What are Physical Therapy and Nursing or RT acceptable?
A patient is disoriented, pulling at lines, and has fluctuating mental status throughout the day. Which A–F bundle element is most directly impacted?
What is D – Delirium: assess, prevent, and manage?
Name one contraindication to Passy-Muir Valve placement.
What is an inflated tracheostomy cuff, severe airway obstruction, or patient intolerance?
ICU delirium is associated with increased length of stay, mortality, and what long-term outcome?
What is long-term cognitive impairment or functional decline?
A patient scores BMAT 4. What does this indicate about their mobility status?
What is independent or near-independent mobility?
Why is interdisciplinary communication important for patient safety?
What is it prevents errors, aligns goals, and improves outcomes?
A ventilated patient is following commands, RASS –1, and hemodynamically stable. PT would like to mobilize the patient. Which A–F bundle element supports this plan?
What is E – Early mobility and exercise?
Before placing a Passy-Muir Valve, what must be done with the tracheostomy cuff?
What is fully deflate the cuff?
Which medication class is commonly associated with an increased risk of ICU delirium?
What are benzodiazepines?
A patient’s HLM improves from 3 yesterday to 5 today. What does this change most likely indicate?
What is improved mobility and functional progress?
Which team member often helps identify medication-related contributors to delirium?
What is pharmacy?
Family members ask how they can help reduce confusion and anxiety in their loved one. Which A–F bundle element focuses on including them in care?
What is F – Family engagement and empowerment?
A patient becomes anxious and desaturates shortly after Passy-Muir Valve placement. What is the FIRST action the team should take?
What is remove the valve and assess the patient?
A patient is RASS –4. How does this level of sedation affect mobility and delirium prevention?
What is mobility is not appropriate and delirium risk is increased due to deep sedation?
A ventilated patient is BMAT 3 and HLM 4. What is an appropriate mobility activity?
What is standing, marching in place, or transferring to a chair with assistance?
PT would like to mobilize a patient, but the patient remains deeply sedated. What is the most appropriate next step?
What is interdisciplinary discussion to reassess sedation and mobility goals?