Marjon Borgert

76 Chapter 4 Table 1. (continued) Author/ year of publication/ country Design Study period Study outcomes ICU Type of bundle Aim of the bundle Methods used in the care bundle design process Titsworth 31 , 2012, USA Observational study Aug’08 – Dec‘10 Catheter-associated urinary tract infections Neuro ICU Urinary Tract Infections (UTI) prevention bundle Reduce the incidence of catheter- associated UTI 1) Review of the literature Álvarez 32, 2014, Spain Quality improvement NR Description of the methods applied to identify the recommendations to be included in the zero-VAP bundle and to accomplish implementation ICUs in general “zero-VAP” bundle Reduction of the national VAP incidence rate by 25% and to less than 9 episodes per 1000 days of mechanical ventilation 1) De ne the objectives of the bundle 2) Selection of VAP prevention measures derived from the literature 3) Classi cation of the interventions as“functional”,“mechanical”or “”pharmacological”. 4) Evaluation of the measures by teams with at least 2 members of the national Task Force team by using GRADE 5) Quantitative assessment by 11 members of the panel considering: 1) quality of the evidence, 2) its safety, 3) its feasibility in Spanish ICUs. 6) Finally, feasibility and cost criteria were applied based on which groups of 7 basic mandatory and 3 highly recommended measures were generated. Harnage 33 , 2007, USA Quality improvement Jan’06- Mar’07 Infection rates Medical, surgical, Trauma, Neurologic ICU Central line bundle Reduce Catheter Related Blood Stream Infections 1) Reviewing and updating the current practices and procedures. 2) Review of the literature 3) Compare the current policies and procedures with the literature. 4) Determine if the policies and procedures matched the evolution of available products 5) meetings with product representatives for the multitude of products used in the placement and care of central venous catheters. 6) Bundle selection was based on available research, CDC recommendations, new product technology, changes required by the nurse and ease of use by the end user. NR: None Reported; ICUs: Intensive cares; CLABSI: Central Line Associated Bloodstream Infection; VAP: Ventilator Associated Pneumonia; UTI: Urinary Tract Infections; MCDA: Multi-criteria decision analysis; FMEA: Failure Mode Evaluation and Analysis; GRADE: Grading of Recommendations, Assessment, Development and Evaluation; RCT: Randomized Clinical Trial; CDC Centers for Disease Control and Prevention.