Purpose of Review <p>The benefits of acute stroke unit care, with nurses as central figures, are well-documented. As care bundles gain traction to enhance evidence-based nursing care, this review explores their development and adaptation in a setting where stroke care is integrated into general neurology. It also highlights key elements for reinforcing competence and interdisciplinary support.</p> Recent Findings <p>Most evidenced based acute stroke unit recommendations focus on hyperacute medical management. In comparison, the literature on decision-making for selecting and evaluating key components of nursing surveillance to support specialized stroke care in geographically smaller settings is sparse although the benefits of nursing care bundles is emerging.</p> Summary <p>Well-structured care bundles, grounded in robust evidence and supported by thorough documentation and effective implementation strategies, provide a clear framework for nursing care, facilitate continuous monitoring, and are useful for enhancing practices especially in smaller stroke units that lack the resources of more comprehensive state-of-the-art units. Tailoring stroke nursing care bundles to local contexts requires an adaptable approach.</p>