The Severe Sepsis Bundles are a distillation of the concepts and recommendations found in the practice guidelines published by the Surviving Sepsis Campaign in 2004.

The Severe Sepsis Bundles are designed to allow teams to follow the timing, sequence, and goals of the individual elements of care, in order to achieve the goal of a 25 percent reduction in mortality from severe sepsis. Individual hospitals should use the bundles to create customized protocols and pathways specific to their institutions.  However, all of the elements in the bundles must be incorporated in those protocols. The addition of other strategies not found in the bundles is not recommended.  The bundle will form the basis for the measurements that improvement teams will conduct to follow their progress as they make changes.

Hospitals should implement two different Severe Sepsis Bundles.  Each bundle articulates requirements for specific timeframes.

• Sepsis Resuscitation Bundle: Tasks that should begin immediately, but must be done within 6 hours for patients with severe sepsis or septic shock.

• Sepsis Management Bundle: Tasks that should begin immediately, but must be done within 24 hours for patients with severe sepsis or septic shock. 

A "bundle" is defined as a group of interventions related to a disease process that, when implemented together, result in better outcomes than when implemented individually. The science behind the elements of the bundle is so well-established that their implementation should be considered a generally accepted practice. Bundle components can be easily measured as completed or not completed. As such, the overall bundle — all of the elements taken together — can also be measured as completed or not completed.

The specific implementation of the bundle is extensively detailed in the Changes section.  In general, teams should take the bundles and build protocols for use at their own institutions.  The protocols should very closely mirror the bundles, but allow flexibility for logistical and other needs specific to the local hospital.  It is important to accurately mirror the content of the bundles in your approach because the measures used to assess your progress are designed around the specifications contained in the bundle elements.

The Severe Sepsis Quality Indicators should be used in conjunction with the bunldes to help improvement teams understand the measures that will be used to evaluate their progress in improving the care of severely septic patients.

[NOTE: A Chinese translation of this tool is also available.]