The online version of this article (doi:10.1186/cc13055) contains supplementary material, which is available to authorized users.
The authors declare that they have no competing interests.
MP conceived of the study and designed the first draft of the checklist. This was revised with the RAG (see below). MP and SS planned the study and intervention. RAG members ensured implementation of the checklist. The SS and MP collected the data, MP analysed the data and both SS and MP prepared the manuscript. All authors read and approved the final manuscript.
Poor communication is a source of risk. This can be particularly significant in areas of high clinical acuity such as intensive care. Ward rounds are points where large amounts of information must be communicated in a time-limited environment with many competing interests. This has the potential to reduce effective communication and risk patient safety. Checklists have been used in many industries to improve communication and mitigate risk. We describe the introduction of a ward round safety checklist ‘DEFAULT’ on a paediatric intensive care unit.
A non-blinded, pre- and post-intervention observational study was undertaken in a 12-bedded Level 3 tertiary PICU between July 2009 and December 2011.
Ward round stakeholders subjectively liked the checklist and felt it improved communication. Introduction of the ward round checklist was associated with an increase in median days between accidental extubations from 14 (range 2 to 86) to 150 (56 to 365) (Mann–Whitney P <0.0001). The ward round checklist was also associated with an increase in the proportion of invasively ventilated patients with target tidal volumes of <8 ml/kg, which increased from 35 of 71 patients at 08.00 representing a proportion of 0.49 (95% CI 0.38 to 0.60) to 23 of 38 (0.61, 0.45 to 0.74). This represented a trend towards an increased proportion of cases in the target range (z = 1.68, P = 0.09).
The introduction of a ward round safety checklist was associated with improved communication and patient safety.
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- ‘Safety by DEFAULT’: introduction and impact of a paediatric ward round checklist
Mark J Peters
- BioMed Central
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