An interprofessional team is meeting to create a care bundle to prevent the development of contractures in patients with limb paralysis from neurological health problems. Which actions should the committee members include when creating this care bundle?
1. Narrow the patient population in which the bundle will be applied.
2. Define the number and type of range-of-motion exercises to be performed.
3. Identify three interventions proven to reduce the development of contractures.
4. Communicate when the bundle has been completed and ready to for implementation.
5. Emphasize that interventions are recommendations to reduce the incidence of contractures.
Correct Answer: 1, 3, 4
Care bundles are multidisciplinary standards that pull together a short list of interventions and treatments that are already recommended and are generally accepted in national guidelines. For a care bundle to be successful, it must be written for a defined patient population in one location. The development of a bundle to prevent contractures in patients with limb paralysis from neurological health problems is too broad and needs to be further defined or narrowed. Bundle elements should be descriptive rather than prescriptive, to allow for customization and appropriate clinical judgment. The bundle should state that range-of-motion exercises are to be done but not identify the number and type of exercises. The bundle should have three to five interventions with strong clinician agreements. The bundles integrate a short list of already recommended guidelines that are accepted nationally or through consensus by local clinicians. The multidisciplinary team develops the bundle. Communication and teamwork are essential to successful implementation of a bundle. Compliance with bundles is measured using all-or-nothing measurement, with a goal of 95% or greater. If any of the interventions are not documented, implementation of the bundle is considered incomplete and no partial credit is given.
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