Standardizing Daily Rounds in the Intensive Care Unit: A Quality Improvement Project
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Authors
Nelson, Theresa
Issue Date
2022-05-12
Type
Poster
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Abstract
Background: An unstandardized daily rounding process in the ICU increases the likelihood of medical error, weakens communication, and may jeopardize patient care. Despite research showing improved care bundle compliance and patient outcomes after standardizing rounds, many ICUs continue to neglect this practice change. The cardiothoracic surgery ICU (CTSICU) at a large academic center lacks a standardized rounding process that complements its expanding, high acuity cardiothoracic surgery program.|Setting: The project was conducted in the 16-bed CTSICU in the Midwest region of the US|Methods: Rounds in the CTSICU were standardized to include multidisciplinary participation by a physician, nurse practitioner, nurse, and pharmacist. Standardization also included team use of a rounding checklist tool and development of personalized care goals for each patient. Additionally, an abbreviated rounding process was added for night shift providers that included a multidisciplinary review and modification of morning goals and checklist completion.|Results: Intervention completion rates dropped significantly throughout project implementation from 40-50% in September to 4-5% in November. The standardized utilization ratio for central lines before and during project implementation remained unchanged, whereas the ratio for indwelling catheters and ICU length of stay decreased slightly.|Conclusion: Although there was no improvement in standardized rounding compliance after project implementation, participant agreement on the importance of rounding checklists increased. Qualitative survey results suggest a role for standardized rounding in improving interdisciplinary communication. Additionally, this project supports current evidence demonstrating that standardized rounding may contribute to decreased indwelling catheter days and ICU length of stay.
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University