Improving Quality Through Nursing Participation at Bedside Rounds in a Pediatric Acute Care Unit: A Pilot Project

J Pediatr Nurs. 2018 Nov-Dec:43:45-55. doi: 10.1016/j.pedn.2018.08.010. Epub 2018 Aug 28.

Abstract

Problem: Implementation of bedside rounds enhances communication and collaboration between physicians and nurses, resulting in improved clinical outcomes. Yet, the literature demonstrates that it remains difficult for nurses to attend rounds if they don't know when they are happening.

Purpose: This project aimed to increase nurses' presence and participation at bedside rounds in a pediatric acute care unit, enhance teamwork and collaboration, and improve quality outcomes.

Design and methods: Nurses carried a pager so that physicians could alert them of rounds. Perception of teamwork and collaboration was assessed via surveys pre- and post-intervention as well as the annual survey evaluating RN and MD interactions from the National Database of Nursing Quality Indicators™ (NDNQI®). Other quality outcome measures included length of stay and patient satisfaction through Press Ganey™ surveys.

Results: Findings demonstrated that when nurses were notified in advance, their participation in rounds increased from 44.4 to 73%. Length of stay decreased from 2.5 days prior to the project to an average of 2.10 days during the project. Scores on inpatient satisfaction surveys increased from 82.4 to 92.2%, and nursing communication improved from 83.3 to 95.65%.

Conclusion: Interprofessional collaboration as reflected by the inclusion of nurses at bedside rounds led to positive outcomes in patient care.

Implications: Increasing nurses' presence and providing them with a role at rounds is an important step towards fostering teamwork and collaboration with physicians and enhancing team-based care in a pediatric inpatient setting. Further research measuring the impact of interprofessional collaboration in healthcare is needed.

Keywords: Bedside rounds; Collaboration; Nurse communication; Pediatric acute care unit; Quality improvement.

MeSH terms

  • Child
  • Child, Preschool
  • Cooperative Behavior
  • Critical Care / organization & administration*
  • Female
  • Hospitals, Pediatric / organization & administration
  • Humans
  • Infant
  • Intensive Care Units, Pediatric / organization & administration
  • Interprofessional Relations*
  • Length of Stay
  • Male
  • Nurse's Role*
  • Patient Care Team / organization & administration
  • Pediatric Nursing / organization & administration
  • Pediatricians / organization & administration
  • Pilot Projects
  • Quality Improvement*
  • Teaching Rounds / organization & administration*
  • United States