Care bundles: improving patient outcomes

The concept of care bundles was developed in 2001 by the Institute for Healthcare Improvement (IHI), as part of an initiative to improve patient outcomes in intensive care units.

Put simply, a care bundle is:

“a small set of evidence-based interventions for a defined patient segment/population and care setting that, when implemented together, will result in significantly better outcomes than when implemented individually” (IHI, 2012).

At EEAST we have defined 10 care bundles that all staff should apply to specific patient groups and conditions. When attending such patients all assessments and tests should be completed unless there is a valid exemption. Such exemptions include the patient being unable to comply or the necessary equipment not being available. All test results, and any exemptions, must be documented on your patient care record.

The 10 care bundles that are currently in use are: 

Care Bundle Condition	Interventions/Tests/Examinations
ST-elevation MI (STEMI)	Aspirin administered GTN administered Analgesia administered Pre- and post-treatment pain score recorded
Stroke	Time of onset FAS test complete Blood pressure recorded Blood glucose recorded
Asthma	Respiratory rate recorded Oxygen administered Beta-II agonist administered Peak flow pre- and post-treatment SpO2 pre- and post-treatment
Below knee fracture	Immobilisation of limb Assessment of circulation distal to fracture Analgesia administered Pre- and post-treatment pain scores recorded
Sepsis	Record suspected sepsis on patient care record
Febrile convulsion	Blood glucose recorded Anti-convulsant administered (where appropriate) SpO2  recorded pre-O2 administration Temperature managed
Pain relief	If original pain score is above two, a second pain score should be recorded post analgesia administration
Diabetes	Blood glucose recorded pre- and post-treatment  Treatment given for hypoglycaemia (where appropriate) Referral made
Dementia	Record use of dementia referral pathway
Falls	Record use of falls register

 

Remember, it is your responsibility to ensure all elements of the care bundle are implemented into your care regime and documented. If there is any reason why any element cannot be applied, the exemption must also be recorded.

Published 23rd May 2015