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Table 4 Definitions of PICU Liberation program: Bundle Performance and Daily Goals (adapted from PUN et al.) [16]

From: Every child, every day, back to play: the PICUstars protocol - implementation of a nurse-led PICU liberation program

Element Days eligible Performance in the last 24 h it was documented that the patient received Performance in the last 24 h it was documented on the daily goal checklist
A All days ≥ 6 pain assessments using the FLACC assessments [26, 27] FLACC goal
B1 Only days when patient received continuous or intermittent sedation A spontaneous awakening trial (SAT) if receiving continuous or intermittent sedative infusions OR sedation target set as “light” in the daily goals Suitability for SAT if receiving continuous or intermittent sedative infusions OR suitability for sedation goal set as “light”
B2 Only days when patient was on ventilatory support A spontaneous breathing trial (SBT) if receiving invasive ventilation Suitability for SBT if receiving invasive ventilation
B3 Only days when patient was on ventilatory support An extubation assessments if receiving invasive ventilation Suitability for extubation assessments if receiving invasive ventilation
C All days ≥ 6 agitation-sedation assessments using the RASS (Richmond Agitation-Sedation Scale [29] RASS goal
D All days ≥ 1 delirium assessments using the CAP-D [31] CAP-D requested
E Only days when patient was not classed as “lizard – for range of motion activities only” ≥ 1 Mobility activity administered that was higher than range of motion Mobility goal (Lizard – passive range of motion unless contraindicated; Koala – in bed activities including sitting; Wombat – out of bed activities including transfers; Kangaroo – activities away from bedspace including ambulatory) set
F Only days when family was present Family member/carer educated on the PICU Liberation bundle and/or participated in at least one of the following: liberation goal setting, cares, neurodevelopmental or early mobility activity, rounds, plan of care. Suitability of family inclusion in liberation goal setting, cares, neurodevelopmental or early mobility activity, rounds, plan of care.
G All days Nutritional assessment tool used OR weight obtained Nutritional goal set
H All days Tool to help personalise the patient for the clinicians administered OR humanism activity administered Humanism goal set
Baby Liberation Only infants “flower” tool to adapt each bundle element to include developmentally appropriate components Baby Liberation goals documented