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Generating bundle recommendations, i.e., recommendations of two or more items together, can satisfy consumer needs, while at the same time increase customers' buying scope and the firm's income.
The objective of the present study was to assess the effectiveness of a daily MDR to improve compliance with the VAP bundle recommendations and other beneficial prophylactic measures in a high-volume critical care unit.
We found that the electronic medical record (EMR) offered health care providers several opportunities to by-pass organizational processes (based on Bladder Bundle recommendations), to continue to use the urinary catheter.
The primary aim of the bundle recommendations is reduction of the three most influential factors contributing to the development and transmission of MDR, namely: 1) adequate prescription of antibiotics; 2) early detection and prevention of cross-colonization of MDR; and 3) elimination of reservoirs [ 8].
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Surprisingly, in 142 patients (42 %) with clinical diagnosis of severe sepsis or septic shock, microbiological culture results were not reported that, if not performed, indicates a poor compliance to the bundles recommendations [20].
The guidelines also emphasize 'bundles' of care for sepsis resuscitation, although the evidence behind some of the bundled recommendations is not strong (that is, using central venous pressure readings to guide volume resuscitation) [ 12].
This bundle of recommendations is different and more extensive than those suggested by the meta-analysis by Roquilly and colleagues.
Jaber and colleagues (same research group who authored the paper under discussion) have previously demonstrated a dramatic reduction in life-threatening cardiopulmonary complications from 34% to 21% (P = 0.03) after the introduction of a bundle of recommendations aimed at preventing intubation complications [ 9].
During this period data collection included epidemiological characteristics and comorbidities, the community-acquired sepsis episode (locale of infection, responsible organism, first intention antibiotherapy and associated organ dysfunction) and the compliance with the SSC bundles and recommendations.
Data collection included epidemiological characteristics and comorbidities, the CAS episode (locale of infection, responsible organism, first intention antibiotherapy and associated organ dysfunction) and the compliance with the SSC bundles and recommendations – following a detailed protocol that contained a summarized description of all SSC guidelines.
The main objective of the "Zero Resistance" project is reduction in the cumulative incidence of patients with ICU-acquired MDR infections by 20 % with a bundle of 10 recommendations.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com