Improving Outcomes Through an LDA Dislodgement Taskforce: Lessons From the SICU

Introduction: LDA dislodgement is a patient safety concern and a cause of prolonged length of stay, costly excess financial resources, and poorer patient outcomes. The amount of LDA dislodgements in the SICU increased, with 30 dislodgements from Decemeber 2023 to May 2024. To maintain exemplary professional practice standards, the LDA Dislodgement Taskforce was formed as a comprehensive intervention to develop care protocols and reduce dislodgement occurrences.


Methods: The LDA Taskforce implemented a targeted initiative to reduce LDA (Line, Drain, and Airway) dislodgement events. This included the development of visual signage and in-service education aimed at stratifying patients into “high-risk” and “medium-risk” categories for dislodgement. Patients were classified as high-risk if they exhibited any three of the following criteria: agitation, a Richmond Agitation-Sedation Scale (RASS) score ≥ +2, a documented history of LDA removal, or active attempts to remove restraints or LDAs. Medium-risk patients were identified by the presence of any three of the following: current or recent sedation (within 12 hours), a positive Confusion Assessment Method for the ICU (CAM-ICU), forgetfulness or confusion, recent extubation, or presence of multiple lines. The taskforce promoted the use of three types of restraints—bilateral wrist, mitts, and freedom splints—for high-risk patients, and two restraint types for medium-risk patients. AI Disclosure: Artificial intelligence was utilized solely for grammatical refinement and formatting. No AI tools were used in generating the original research content or data interpretation.


Results: From June to November 2024, there were 15 LDA dislodgements, reflecting a 50% reduction since the project's initiation. From December 2024 to May 2025, there were 11 dislodgements, demonstrating the continued effectiveness and sustainability of the action plan.


Conclusions: The LDA Dislodgement Taskforce was successful in decreasing the amount of LDA dislodgements in the SICU. The LDA dislodgement in-service is now part of the SICU unit orientation, signage for “high-risk” and “medium-risk” patients is used, and progress is monitored and regularly mentioned in weekly staff huddles.