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Managing quality bundles can be challenging for clinical nurses. A study was undertaken to examine quality bundle volumes by patient and nursing perceptions in managing those volumes.Quantitative and qualitative data were collected from more than 400 patients and their clinical nurses in five hospitals to provide insight into bedside complexities related to quality bundles.Patients were assigned up to six bundles; critical care patients had the most bundle assignments.Nurses (N = 180) responded to a three-item survey about managing quality bundles. Although 39% of the respondents said they were always aware of the nursing interventions, only 16% responded that they could always complete them.Strategies to effectively implement quality interventions are critical to nursing workflow and, ultimately, patient care. Workflow assessments, embedded reminders, checklists, and improved data transparency at the bedside are needed to improve quality bundle compliance.