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WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit

OBJECTIVE: To implement a daily rounding tool in a pediatric intensive care unit (PICU) to improve the discussion performance of identified clinical elements. We hypothesized that a semi-structured rounding tool created by a multidisciplinary team would be successfully implemented and sustained in t...

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Autores principales: Ganesan, Rani, Rajakumar, Priya, Fogg, Louis, Silvestri, Jean, Kane, Jason M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132891/
https://www.ncbi.nlm.nih.gov/pubmed/30229180
http://dx.doi.org/10.1097/pq9.0000000000000044
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author Ganesan, Rani
Rajakumar, Priya
Fogg, Louis
Silvestri, Jean
Kane, Jason M.
author_facet Ganesan, Rani
Rajakumar, Priya
Fogg, Louis
Silvestri, Jean
Kane, Jason M.
author_sort Ganesan, Rani
collection PubMed
description OBJECTIVE: To implement a daily rounding tool in a pediatric intensive care unit (PICU) to improve the discussion performance of identified clinical elements. We hypothesized that a semi-structured rounding tool created by a multidisciplinary team would be successfully implemented and sustained in the PICU. PATIENTS AND METHODS: A pre–post interventional study was conducted in a multidisciplinary medical-surgical PICU. Baseline data collection of undisclosed clinical elements was performed by covert observers, which resulted in the development of a comprehensive, nurse-driven rounding checklist. Frequencies of pre- and postintervention metrics were assessed after implementation, and sustainability was assessed at 5 years. RESULTS: Six months after implementation, 70% (7/10) of checklist elements demonstrated significant improvement. Five years after implementation, 172 of a possible 222 (74%) checklists were collected. Eighty percentage (8/10) of the measures sustained discussion frequency after 5 years of use. Nursing presence significantly improved at year 5 compared with the preimplementation period. Nursing satisfaction surveys distributed at year 5 showed that the rounding tool was useful and nurses were confident in understanding care plans at the end of rounds. Ninety-eight percentage of checklists revealed discrete transcription of qualitative daily goals. CONCLUSIONS: A semi-structured rounding tool created by a multidisciplinary team was successfully implemented, and performance was sustained at 5 years. This initiative led to improved bedside nursing presence during patient care rounds.
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spelling pubmed-61328912018-09-18 WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit Ganesan, Rani Rajakumar, Priya Fogg, Louis Silvestri, Jean Kane, Jason M. Pediatr Qual Saf Individual QI Projects from Single Institutions OBJECTIVE: To implement a daily rounding tool in a pediatric intensive care unit (PICU) to improve the discussion performance of identified clinical elements. We hypothesized that a semi-structured rounding tool created by a multidisciplinary team would be successfully implemented and sustained in the PICU. PATIENTS AND METHODS: A pre–post interventional study was conducted in a multidisciplinary medical-surgical PICU. Baseline data collection of undisclosed clinical elements was performed by covert observers, which resulted in the development of a comprehensive, nurse-driven rounding checklist. Frequencies of pre- and postintervention metrics were assessed after implementation, and sustainability was assessed at 5 years. RESULTS: Six months after implementation, 70% (7/10) of checklist elements demonstrated significant improvement. Five years after implementation, 172 of a possible 222 (74%) checklists were collected. Eighty percentage (8/10) of the measures sustained discussion frequency after 5 years of use. Nursing presence significantly improved at year 5 compared with the preimplementation period. Nursing satisfaction surveys distributed at year 5 showed that the rounding tool was useful and nurses were confident in understanding care plans at the end of rounds. Ninety-eight percentage of checklists revealed discrete transcription of qualitative daily goals. CONCLUSIONS: A semi-structured rounding tool created by a multidisciplinary team was successfully implemented, and performance was sustained at 5 years. This initiative led to improved bedside nursing presence during patient care rounds. Wolters Kluwer Health 2017-11-17 /pmc/articles/PMC6132891/ /pubmed/30229180 http://dx.doi.org/10.1097/pq9.0000000000000044 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY) (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Individual QI Projects from Single Institutions
Ganesan, Rani
Rajakumar, Priya
Fogg, Louis
Silvestri, Jean
Kane, Jason M.
WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit
title WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit
title_full WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit
title_fullStr WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit
title_full_unstemmed WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit
title_short WE CARE 4 KIDS: Use of a Rounding Tool in the Pediatric Intensive Care Unit
title_sort we care 4 kids: use of a rounding tool in the pediatric intensive care unit
topic Individual QI Projects from Single Institutions
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132891/
https://www.ncbi.nlm.nih.gov/pubmed/30229180
http://dx.doi.org/10.1097/pq9.0000000000000044
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