Prevention measures

We are always working to make sure you are safe while you are a patient at a Vidant Health hospital. We follow certain practices to help prevent infections and harmful occurrences while patients are in our hospitals. Grouped together, these steps are referred to as a “bundle.” We measure how well we do at following all the steps in a bundle. How we perform is called our compliance rate.

Select a measure in the left menu to see how we perform.

Institute for Healthcare Improvement (IHI) vice president and patient safety expert, Carol Haraden, PhD, comments on the power and popularity of “bundles” in improvement initiatives:

What is a bundle?

A bundle is a structured way of improving the processes of care and patient outcomes: a small, straightforward set of evidence-based practices — generally three to five — that, when performed collectively and reliably, have been proven to improve patient outcomes.

What makes a bundle so special?

The power of a bundle comes from the body of science behind it and the method of execution: with complete consistency. It’s not that the preventive steps in a bundle are new; they’re well established best practices, but they’re often not performed uniformly, making treatment unreliable. A bundle ties the steps together into a package of interventions that people know must be followed for every patient, every single time.

So a bundle is a list of the right things to do for a given patient?

It resembles a list, but a bundle is more than that. A bundle has specific preventive steps that make it unique.

  • The changes are all necessary and all sufficient, so if you have four steps in the bundle and you remove any one of them, you will not get the same results — meaning: the patient won’t have as high a chance of getting better. It’s a cohesive unit of steps that must all be completed to succeed.
  • The preventive steps are all based on randomized controlled trials, called Level 1 evidence. They’ve been proven in scientific tests and are accepted and well-established. A bundle focuses on how to deliver the best care — not what the care should be.
  • The changes in a bundle are clear-cut and straightforward; they involve all-or-nothing measurement. Successfully completing each step is a simple and straightforward process. It’s a “Yes” or “No” answer: Successfully implementing a bundle is clear-cut: “Yes, I completed the ENTIRE bundle, or No, I did not complete the ENTIRE bundle.”

Can you give an example?

Below are two bundles that have been incredibly effective helping hospitals reduce to nearly zero the incidence of deadly infections that used to be so common they were accepted as unavoidable. 

  • Central Line Bundle: This is a set of five steps to help prevent “catheter-related blood stream infections,” deadly bacterial infections that can be introduced through an IV in a patient’s vein supplying food, medications, blood or fluid. The steps are simple, common sense tasks: using proper hygiene and sterile contact barriers; properly cleaning the patient’s skin; finding the best vein possible for the IV; checking every day for infection; and removing or changing the line only when needed.   
  • Ventilator Bundle: Ventilator-associated pneumonia (VAP) is a serious lung infection that can happen to patients on a ventilator. The Ventilator Bundle has four care steps: raising the head of the patient’s bed between 30 and 40 degrees; giving the patient medication to prevent stomach ulcers; preventing blood clots when patients are inactive; and seeing if patients can breathe on their own without a ventilator.