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ELECTIVE PROJECT
(INFECION CONTROL ELECTIVES)
AUTHORS : AHAS DHAS
BANU SHREE
LAUREL GLADLIN
PAVISREE
PAVITHRA
GUIDE:
SIGNAURE OF THE DEAN
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CARE BUNDLE AUDIT AT TERTIARY CENTRE
TITLE:
Care bundle audit compliance of device related hospital associated
infection at the tertiary care centre.
Authors: [Link], BHANU SHREE.O, LAUREL
GLADLIN.A, PAVISREE.R, PAVITHRA.S,
Third year mbbs students, Annapoorana medical college and hospitals
Abstract:
Healthcare associated infections are one of the most prevalent and
undesirable consequence of healthcare delivery. Notable examples
include ventilator associated pneumonia, central line associated blood
stream infections, catheter associated urinary tract infections. A
prospective study was conducted to evaluate the adherence to care
bundles for device associated infections (DAI) at a tertiary care
hospital. The study analysed 50 cases from March 2023 using case
based scenarios. The compliance rates were as follows: 71.42% for
ventilator associated pneumonia, 64.7% for central like associated
bloodstream infections, and 46.15% for catheter associated urinary
tract infections
KEYWORDS: HAI, Care bundle, Audit
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INTRODUCTION
Healthcare-associated infections (HAIs)—also known as noso comial
infections—are infections acquired in clinical settings (hospitals,
nursing homes, outpatient clinics, etc.) and major contributors to
patient morbidity, mortality, prolonged hospitalization, and costs.
Despite established infection-control guidelines, inconsistent
adherence to practices like hand hygiene and barrier precautions
continues to undermine efforts to reduce HAIs.
Care bundles—coordinated sets of 3–6 evidence-based interventions
delivered together—have been developed to standardize clinical
practice and improve outcomes across multiple HAI types. Originally
advanced in critical care (e.g., ventilator-associated pneumonia
[VAP], central line-associated bloodstream infection [CLABSI],
bundles often include key components such as hand hygiene, aseptic
technique, device maintenance protocols, and daily necessity checks.
AIM
Audit of care bundle adherence rate of device related health care
associated infections at tertiary health care centre.
OBJECTIVE
1. To audit adherence of device related care bundle element for
the given case scenario.
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2. To calculate adherence rate of CAUTI, CLABSI, VAP Care
bundles.
MATERIALS AND METHODS:
Period of study: JUNE,2025
Type of study: Prospective descriptive study
Study population: case based scenarios
No. Of cases: 30
Data collection: Care bundle audit form given by department of
microbiology, AMCH.
The format for audit is enclosed and given below as table 2, 3 and 4
STASICAL PLAN AND DATA ANALYSIS:
Care bundle adherence of VAP, CAUTI, CLABSI are calculated as
below
CAUTI care bundle = adherence to care bundle x 100
adherence rate Total no. of patients on Foleys catheter
CLASBI care bundle = adherence to care bundle x100
adherence rated total no. of Patients on central line
VAP care bundle = adherence to care bundle x100
adherence rate total no. of patients on ventilator
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RESULTS :
TABLE:ADHERENCE RATE OF DIFFERENT HAI CARE
SLNO. Patient no. UC bundle CL bundle MV bundle
1. Case-1 No - -
2. Case-2 No Yes -
3. Case-3 No No -
4. Case-4 Yes No -
5. Case-5 Yes Yes -
6. Case-6 Yes No -
7. Case -7 Yes - No
8. Case-8 Yes - -
9. Case-9 Yes - -
10. Case-10 Yes - No
11. Case-11 No - Yes
12. Case-12 Yes Yes -
13. Case-13 Yes - -
14. Case-14 - No -
15. Case-15 No - -
16. Case-16 No No -
17. Case-17 Yes - -
18. Case-18 Yes - -
19. Case-19 Yes Yes -
20. Case-20 Yes - -
21. Case-21 Yes - -
22. Case-22 Yes - -
23. Case-23 No - -
24. Case-24 Yes No -
25. Case-25 Yes - -
26. Case-26 Yes Yes -
27. Case-27 Yes - Yes
28. Case-28 Yes - -
29. Case-29 Yes - -
30. Case-30 Yes - -
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UC Bundle adherence rate 75.86%
CL bundle adherence rate 45.4%
MV bundle adherence rate 50%
In the present study, we audited the adherence to care bundle for all
device related infections whuch is as follows in the figure -1
UC bundle CL bundle MV bundle
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DISCUSSION
Although the concept of care bundles was introduced
by clinicians years ago, the critical importance of
adhering to each individual element has only been fully
appreciated more recently. A care bundle functions as
a unified protocol, ensuring that every essential step in
patient care is consistently implemented and properly
documented. Importantly, failure to comply with even
a single component renders the entire bundle non-
compliant. This strict all-or-none principle enhances
reliability, minimizes preventable complications,
shortens hospital stays, and improves overall patient
outcomes. Device-associated infections remain a
significant yet preventable threat to patient safety,
primarily due to the use of invasive devices that can
lead to mucosal breaches or surface colonization,
thereby increasing the risk of healthcare-associated
infections (HAIs). In our audit, we evaluated adherence
to the care bundle approach. Numerous studies have
reported a 19% reduction in ventilator-associated
pneumonia (VAP) rates following the implementation
of care bundles. Catheter-associated urinary tract
infection (CAUTI), which accounts for nearly 40% of all
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HAIs globally, is recognized as the most common. In
our study, device-associated infections occurred
exclusively in cases where even one element of the
care bundle was not followed
CONCLUSION
In the present study the adherence to care bundle for
VAP was higher 50%, followed by CAUTI 75.86% and
CLABSI 45.4%. Our results emphasises the importance
of implementation of the bundle care approach on
reducing the occurrence of device associated infections
and evaluation of bundle adherence by regular audits
are the key elements to achieve a greater reduction of
DAIs.
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