Intensive care delirium prevention is currently a practice improvement goal of the Society of Critical Care Medicine. Delirium increases morbidity, mortality, time mechanically ventilated, length of stay, and health care spending. The Clinical Practice Guidelines for the Management of Pain, Agitation, and Delirium in Adult Patients in the Intensive Care Unit (PAD guidelines) were revised and published in 2013. The ICU Delirium and Cognitive Impairment Study Group at Vanderbilt University have developed the ABCDEF Bundle protocol as a way of operationalizing the 2013 PAD guidelines. Implementation of the ABCDEF Bundle protocol has been shown to decrease occurrence and duration of delirium while improving morbidity and mortality therefore decreasing length of stay. The purpose of this project is to develop an implementation and evaluation plan of the ABCDEF Bundle for a community hospital's TSICU in Arizona. The Squire guidelines for quality improvement reporting are followed for this project. Implementation and evaluation of the ABCDEF bundle are explained in detail.

This case study investigated the adoption and diffusion of the Blackboard platform, a widely used Learning Management System (LMS), as an instructional tool within a community college setting. The study explored faculty members’ adoption patterns, perceptions, and factors influencing the utilization of the Blackboard platform, drawing on Rogers’s diffusion of innovation theory and Chickering and Ehrman’s “Seven Principles: Technology as a Lever” as theoretical frameworks. A cross-sectional online survey was conducted to gather insights from faculty members, capturing their usage patterns, perceptions of the Blackboard platform, and specific components and tools utilized when integrating the LMS into their courses. An overall theme emerged, where nonusers expressed agreement more than did users regarding their lack of exposure to the Blackboard platform, limited opportunities to observe its usage, and the inability to try it properly. The study revealed that the majority of users employed various components of the Blackboard platform, including announcements, full grade center, course copy, tests, surveys, pools, and discussion boards. However, other components such as export/achieve course, dashboard, import course cartridge, course calendar, course report, and journal were employed by fewer faculty members. These components have the potential to enhance communication between faculty and students. The study’s findings highlight the need for targeted professional development activities to address the concerns of nonusers and encourage the adoption and utilization of the Blackboard platform. The limitations of the study suggest the importance of a comprehensive research design to fully grasp the complexities and factors influencing the adoption of learning management systems in community college settings. The recommendations derived from this research contribute to a better understanding of the adoption and use of learning management systems as instructional tools, emphasizing the significance of user satisfaction, effective strategies for promoting adoption, and implications for faculty training and institutional strategies.