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Using care bundles to prevent infection in neonatal and paediatric ICUs

Lachman, Petera; Yuen, Sebastianb

Current Opinion in Infectious Diseases: June 2009 - Volume 22 - Issue 3 - p 224–228
doi: 10.1097/QCO.0b013e3283297b68
Paediatric and neonatal infections: Edited by Paul T. Heath

Purpose of review 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.

Recent findings 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.

Summary 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.

aGreat Ormond Street Hospital for Children NHS Trust, Royal Free Hampstead NHS Trust, UK

bRoyal Free Hampstead NHS Trust, NHS Institute for Innovation and Improvement, London, UK

Correspondence to Peter Lachman, Consultant Paediatrician, Consultant for Service Redesign and Transformation, Great Ormond Street Hospital for Children NHS Trust, Great Ormond Street, London WC1N 3JH, UK Tel: +44 20 7405 9200 x 7929; fax: 44 207 4190441; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.