Care bundles: improving patient outcomes

Staff with patient in ambulance

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


ST-elevation MI (STEMI)

Aspirin administered
GTN administered
Analgesia administered
Pre- and post-treatment pain score recorded


Time of onset
FAS test complete
Blood pressure recorded
Blood glucose recorded


Respiratory rate recorded
Oxygen administered
Beta-II agonist administered
Peak flow pre- and post-treatment
SpOpre- and post-treatment

Below knee fracture

Immobilisation of limb
Assessment of circulation distal to fracture
Analgesia administered
Pre- and post-treatment pain scores recorded 


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 


Blood glucose recorded pre- and post-treatment  Treatment given for hypoglycaemia (where appropriate)
Referral made


Record use of dementia referral pathway 


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 


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