Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project

Background: Patients admitted to critical care need timely interventions after evaluating all clinical parameters. This study aims to assess the impact of the comprehensive rounding checklist on physician compliance and patient-related outcomes in a multidisciplinary pediatric intensive care unit (P...

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Main Authors: Awais Abbas, Faris Abdul Aziz, Naveed Ur Rehman Siddiqui, Yasmin Hashwani, Iraj Khan, Aniqa Abdul Rasool, Anwar Ul Haque, Qalab Abbas
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Journal of Pediatric Critical Care
Subjects:
Online Access:http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2023;volume=10;issue=5;spage=213;epage=219;aulast=Abbas
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author Awais Abbas
Faris Abdul Aziz
Naveed Ur Rehman Siddiqui
Yasmin Hashwani
Iraj Khan
Aniqa Abdul Rasool
Anwar Ul Haque
Qalab Abbas
author_facet Awais Abbas
Faris Abdul Aziz
Naveed Ur Rehman Siddiqui
Yasmin Hashwani
Iraj Khan
Aniqa Abdul Rasool
Anwar Ul Haque
Qalab Abbas
author_sort Awais Abbas
collection DOAJ
description Background: Patients admitted to critical care need timely interventions after evaluating all clinical parameters. This study aims to assess the impact of the comprehensive rounding checklist on physician compliance and patient-related outcomes in a multidisciplinary pediatric intensive care unit (PICU). Subjects and Methods: This prospective observational study was conducted in two phases over period of 2 months at multidisciplinary PICU from Pakistan. A structured rounding checklist of 35 components encompassing patient care was introduced and implemented in the PICU. During the preimplementation phase, a nurse took notes of relevant patient clinical details missed by the physician during the round, included them in the rounding checklist. And during the implementation phase, the nurse actively intervened when a physician did not discuss a particular component during the round. All components discussed were check marked. Results: The checklist was completed for 812 rounds (162 patients) in preimplementation and 2348 rounds (590 patients) in the postimplementation phase. Most frequently missed components in the preimplementation phase were checking for surgical site infection (8.9%), discharge plan (7.5%), deep vein thrombosis (DVT) prophylaxis (7.3%), and ventilator-associated pneumonia bundles (7.0%). Whereas, during the postimplementation phase, resident teaching (8.0%), discharge plan (7.2%), and DVT prophylaxis (6.5%) were most frequently missed. Hospital length of stay decreased from 4.5 ± 3.7 to 4.1 ± 2.9 days (P = 0.05), and overall mortality decreased from 19% to 11.4% (P < 0.05). Conclusions: Introducing the checklist with a prompter, improved physician compliance and patient-related outcomes in our PICU.
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spelling doaj.art-29ebcadc47c541f59c44a92d06f295dd2023-10-30T10:27:36ZengWolters Kluwer Medknow PublicationsJournal of Pediatric Critical Care2349-65922455-70992023-01-0110521321910.4103/jpcc.jpcc_67_23Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement projectAwais AbbasFaris Abdul AzizNaveed Ur Rehman SiddiquiYasmin HashwaniIraj KhanAniqa Abdul RasoolAnwar Ul HaqueQalab AbbasBackground: Patients admitted to critical care need timely interventions after evaluating all clinical parameters. This study aims to assess the impact of the comprehensive rounding checklist on physician compliance and patient-related outcomes in a multidisciplinary pediatric intensive care unit (PICU). Subjects and Methods: This prospective observational study was conducted in two phases over period of 2 months at multidisciplinary PICU from Pakistan. A structured rounding checklist of 35 components encompassing patient care was introduced and implemented in the PICU. During the preimplementation phase, a nurse took notes of relevant patient clinical details missed by the physician during the round, included them in the rounding checklist. And during the implementation phase, the nurse actively intervened when a physician did not discuss a particular component during the round. All components discussed were check marked. Results: The checklist was completed for 812 rounds (162 patients) in preimplementation and 2348 rounds (590 patients) in the postimplementation phase. Most frequently missed components in the preimplementation phase were checking for surgical site infection (8.9%), discharge plan (7.5%), deep vein thrombosis (DVT) prophylaxis (7.3%), and ventilator-associated pneumonia bundles (7.0%). Whereas, during the postimplementation phase, resident teaching (8.0%), discharge plan (7.2%), and DVT prophylaxis (6.5%) were most frequently missed. Hospital length of stay decreased from 4.5 ± 3.7 to 4.1 ± 2.9 days (P = 0.05), and overall mortality decreased from 19% to 11.4% (P < 0.05). Conclusions: Introducing the checklist with a prompter, improved physician compliance and patient-related outcomes in our PICU.http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2023;volume=10;issue=5;spage=213;epage=219;aulast=Abbaschecklistpediatric intensive unitquality improvement
spellingShingle Awais Abbas
Faris Abdul Aziz
Naveed Ur Rehman Siddiqui
Yasmin Hashwani
Iraj Khan
Aniqa Abdul Rasool
Anwar Ul Haque
Qalab Abbas
Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project
Journal of Pediatric Critical Care
checklist
pediatric intensive unit
quality improvement
title Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project
title_full Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project
title_fullStr Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project
title_full_unstemmed Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project
title_short Impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country: A quality improvement project
title_sort impact of introduction of a rounding checklist in a pediatric intensive care unit of a developing country a quality improvement project
topic checklist
pediatric intensive unit
quality improvement
url http://www.jpcc.org.in/article.asp?issn=2349-6592;year=2023;volume=10;issue=5;spage=213;epage=219;aulast=Abbas
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