Acute Kidney Injury Care Bundles

Acute kidney injury (AKI) is a common complication that occurs in hospitalized patients and appears susceptible to a wide variability in practice. This may lead to suboptimal quality of care. The concept of a 'care bundle' for AKI has been proposed to improve the reliability and quality of care. A bundle is designed to be a structured method of improving care processes and outcomes. It contains a small set of evidence-based practices intended for a defined population and care setting. The Institute for Healthcare Improvement has developed guidelines for the design of care bundles. Care bundles for critically ill patients focusing on mechanical ventilation, central venous catheters, and sepsis have been widely implemented with modest success in terms of compliance and impact on care processes and outcomes. A care bundle for AKI is highly desired, given the observed practice variation and indication of poor care for AKI patients; however, existing proposals are too comprehensive and have not been focused on a defined population at-risk, clinical context or setting. They have also not engaged local stakeholders in the process.