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Outcomes of Implementing a Care Bundle for the Early Management of Patients with Acute Upper Gastrointestinal Bleeding

Article

Last updated: 28 Dec 2024

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Abstract

Background: Care bundles are the most common form of standardizing patient care that can 
lead to a high quality of care for frequent admission diagnoses. Gastrointestinal (GI) bleeding is still 
a prevalent and potentially fatal emergency problem that encounters critically ill patients. Critical 
care nurses play a crucial role in the implementation of standards of care through recognizing the 
importance of early and timely management as rapid resuscitation and early endoscopy are 
associated with better outcomes. The British society of gastroenterology emphasized ongoing 
differences in practice and inadequate management of patients with acute upper GIT haemorrhage. 
That is why, major initiatives such as the acute upper GI bleeding bundle are still required to address 
these differences and improve patients' clinical outcomes. Objective: To determine the outcomes of 
implementing a care bundle for the early management of patients with acute upper gastrointestinal 
bleeding Setting: This study was conducted in the Hematemesis intensive care unit of Alexandria 
Main University Hospital, Egypt. Subjects: A convenience sample of 60 newly admitted adult patients 
with acute upper gastrointestinal bleeding were included in this study. Patients were assigned into two 
equal groups (30 patients each). Tool: “Assessment of Upper Gastrointestinal Bleeding Bundle 
Implementation Outcomes" is the tool used to collect the data of this study. Results: There was a 
statistically significant difference was observed between the study and control groups in the first, 
second, and third day of MAP readings (p= 0.001, <0.001 and 0.013) respectively. Time waiting until 
doing the endoscopy was less for the study group compared to the control group with significant 
difference between both groups. Mortality rate, incidence of rebleeding and length of stay were higher 
in the control group compared to the study group with no statistically significant differences.
Conclusion: implementation of a care bundle for acute upper GIT bleeding patients can lead to 
improvement of their management and outcomes. Recommendations: Critical care nurses should 
collaborate with other health team members in the implementation of upper GIT bleeding bundle of 
care. Hospital administration should conduct educational training to health team members about
upper GIT bleeding bundle and its importance in improving patients' outcomes

DOI

10.21608/asalexu.2023.300020

Keywords

Patients’ outcomes, Care Bundle, Acute upper gastrointestinal bleeding

Authors

First Name

Samah

Last Name

Mohamed

MiddleName

Anwar

Affiliation

Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Email

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City

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Orcid

-

First Name

Ahmed

Last Name

Zarea

MiddleName

Ismail

Affiliation

Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Email

-

City

-

Orcid

-

First Name

Bassem

Last Name

Beshay

MiddleName

Nashaat

Affiliation

Critical care medicine, Faculty of medicine, Alexandria University

Email

-

City

-

Orcid

-

First Name

Amal

Last Name

Nicola

MiddleName

Kadry

Affiliation

Critical Care and Emergency Nursing, Faculty of Nursing, Alexandria University

Email

-

City

-

Orcid

-

Volume

25

Article Issue

1

Related Issue

41411

Issue Date

2023-03-01

Receive Date

2023-05-22

Publish Date

2023-03-01

Page Start

126

Page End

138

Print ISSN

1687-3858

Link

https://asalexu.journals.ekb.eg/article_300020.html

Detail API

https://asalexu.journals.ekb.eg/service?article_code=300020

Order

300,020

Type

Research articles

Type Code

2,129

Publication Type

Journal

Publication Title

Alexandria Scientific Nursing Journal

Publication Link

https://asalexu.journals.ekb.eg/

MainTitle

Outcomes of Implementing a Care Bundle for the Early Management of Patients with Acute Upper Gastrointestinal Bleeding

Details

Type

Article

Created At

28 Dec 2024