Identifying the Bundle/Care Development Process in Clinical Risk Management: A Systematic Review.

Area of Science:

• Healthcare Quality Improvement
• Clinical Risk Management
• Evidence-Based Practice

Background:

• Care Bundles (BCBs) are sets of evidence-based interventions aimed at enhancing patient care quality and outcomes.
• International research confirms BCBs' effectiveness in reducing morbidity and mortality.
• While the Institute for Healthcare Improvement (IHI) defined BCBs, a standardized development process is lacking.

Purpose of the Study:

• To systematically identify and describe the development process of Care Bundles (BCBs) in clinical risk scenarios.
• To analyze the methodologies employed in BCB development between September 2005 and September 2023.

Main Methods:

• A systematic review adhering to PRISMA guidelines was performed.
• Databases searched included PubMed, Embase, and CINAHL, supplemented by manual searches.
• Studies detailing BCB development processes for clinical risk management were included.

Main Results:

• Out of 1372 retrieved studies, 16 were included after screening.
• Identified BCB development methods include IHI guidelines, expert consensus, international guidelines, and flowcharts.
• Commonly addressed clinical risks include ventilator-associated pneumonia, surgical site infections, catheter-associated infections, and sepsis.

Conclusions:

• The study outlines effective methods for developing evidence-based Care Bundles (BCBs).
• BCBs facilitate compliance monitoring within healthcare teams.
• A significant limitation is the scarcity of studies on BCB development methodology, necessitating further research to optimize intervention strategies.