Aims & Objectives:
Effective communication during multidisciplinary ward rounds in PICU is crucial but can be difficult. Checklists have been used in clinical settings, including intensive care, to improve communication and mitigate risk. We sought to introduce a ward round checklist in our PICU to enhance nurse participation, ensure holistic discussion and aid overall communication.
The mnemonic VALUED was developed: V-ventilation/endotracheal tube, A-analgesia/sedation, L-lines/fluids/feeds, U-ulcer prophylaxis, E-everybody (family/social issues, other teams), D-drugs. After each patient discussion on ward rounds, the bedside nurse runs through the VALUED checklist. Prior to and 3 months after implementation of the checklist, nurses completed questionnaires regarding their satisfaction with ward rounds.
Questionnaire results are summarised in the table. Introduction of the VALUED checklist was associated with a significant improvement in nurses feeling included on ward rounds (90% responding “most of the time” or “always” compared to 70% at baseline, χ2 5.3, P=0.02). There was a trend to bedside nurses feeling more comfortable speaking on ward rounds. Significantly more nurses felt staff or family concerns are now addressed at least most of the time (92% v 44%, χ2 25.3, P<0.001). Results were similar for all grades of nursing staff though senior nurses were more comfortable on ward rounds at baseline. Questionnaire comments about VALUED were universally favourable.
The positive checklist VALUED has enhanced nurse participation in PICU ward rounds and improved discussion of wider family/social issues. Work is ongoing to identify objective evidence of improved patient care.