Using care bundles to prevent infection in neonatal and paediatric ICUs.
OBJECTIVE
Quality and safety of care are national priorities. Healthcare-acquired infections are now considered preventable and unacceptable. Care bundles are used to prevent and treat health-care acquired infections in adults. This paper considers the evidence and context for their use in children.


RESULTS
There is evidence that care bundles are effective in the adult literature. There have been few reports in the paediatric literature on the implementation of care bundles in children. Paediatric reports focus on the impact of interventions to reduce ventilator-associated pneumonia and central line infections. Recent articles suggest that care bundles are beneficial as part of a comprehensive improvement programme in the ICU. Other papers confirm that ventilator-associated pneumonia bundles can be translated from adults to children, supporting the business case for improving quality.


CONCLUSIONS
The adult and paediatric literature agree that care bundles are valuable tools for ensuring that evidence-based medicine is delivered reliably. Care bundles should be adopted in paediatric and neonatal units. In particular, if applied correctly, they are likely to significantly reduce certain health-care acquired infections. Further research is needed to refine the individual elements of the bundles and to evaluate new applications for them.
Lachman
Peter
P
Great Ormond Street Hospital for Children NHS Trust, Royal Free Hampstead NHS Trust, UK. peter.lachman@gosh.nhs.uk
Yuen
Sebastian
S
D019090:Case Management; D003428:Cross Infection / Q000517:prevention & control* / Q000628:therapy*; D006801:Humans; D017053:Infection Control / Q000379:methods*; D007363:Intensive Care Units, Neonatal; D015278:Intensive Care Units, Pediatric