Bundles and ventilator-acquired pneumonia

Abstract

The Institute for Healthcare Improvement (IHI) developed the concept of “bundles” to help healthcare providers to improve the reliability of delivery of essential healthcare processes. “Bundles” are a grouping of a small and simple set of practices — generally three to five — which are well established practices — when used individually, are found to be effective to improve patients’ outcomes — when performed collectively and reliably are expected to result in a better outcome than when implemented individually. The following steps have been recommended for the development of a bundle: identify and implement a set of three to six evidence-based clinical practices and measure compliance with the clinical practices as “all” or “nothing”, that combines the best of medical and improvement sciences: In this review, we discuss how to design a “bundle” to improve the prevention of ventilator-acquired pneumonia. Although some authors have reported dramatic reduction in the rate of ventilator-acquired pneumonia, no study has yet demonstrated the effectiveness of this methodology on the patients’ outcomes.