Implementing Rounding Checklists in a Pediatric Oncologic Intensive Care Unit
Mary Katherine Gardner,
Patricia J. Amado,
Muhummad Usman Baig,
Sana Mohiuddin,
Avis Harden,
Linette J. Ewing,
Shehla Razvi,
Jose A. Cortes,
Rodrigo Mejia,
Demetrios Petropoulos,
Priti Tewari,
Ali H. Ahmad
Affiliations
Mary Katherine Gardner
Pediatric Critical Care, Division of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Patricia J. Amado
Pediatric Critical Care, Division of Nursing, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Muhummad Usman Baig
Pediatric Oncology Fellowship Program, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Sana Mohiuddin
Pediatric Oncology Fellowship Program, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Avis Harden
Pediatric Oncology Fellowship Program, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Linette J. Ewing
Section of Pediatric Critical Care, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Shehla Razvi
Section of Pediatric Critical Care, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Jose A. Cortes
Section of Pediatric Critical Care, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Rodrigo Mejia
Section of Pediatric Critical Care, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Demetrios Petropoulos
Section of Pediatric Stem Cell Transplantation and Cellular Therapy, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Priti Tewari
Section of Pediatric Stem Cell Transplantation and Cellular Therapy, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Ali H. Ahmad
Section of Pediatric Critical Care, Department of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
Standardized rounding checklists during multidisciplinary rounds (MDR) can reduce medical errors and decrease length of pediatric intensive care unit (PICU) and hospital stay. We added a standardized process for MDR in our oncologic PICU. Our study was a quality improvement initiative, utilizing a four-stage Plan–Do–Study–Act (PDSA) model to standardize MDR in our PICU over 3 months, from January 2020 to March 2020. We distributed surveys to PICU RNs to assess their understanding regarding communication during MDR. We created a standardized rounding checklist that addressed key elements during MDR. Safety event reports before and after implementation of our initiative were retrospectively reviewed to assess our initiative’s impact on safety events. Our intervention increased standardization of PICU MDR from 0% to 70% over three months, from January 2020 to March 2020. We sustained a rate of zero for CLABSI, CAUTI, and VAP during the 12-month period prior to, during, and post-intervention. Implementation of a standardized rounding checklist may improve closed-loop communication amongst the healthcare team, facilitate dialogue between patients’ families and the healthcare team, and reduce safety events. Additional staffing for resource RNs, who assist with high acuity patients, has also facilitated bedside RN participation in MDR, without interruptions in clinical care.
