Structured, nurse-led ward rounds to improve interprofessional communication and optimize care of vascular surgery patients: a best practice implementation project.
Nicholas Wee Siong Neo, Yao Li, Ailene Bandoy Salazar, Jessica Kai Lun Gan, Jun Jie Ng, Poh Chi Tho
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引用次数: 0
Abstract
Introduction: Ward rounds are crucial inpatient activities during which patients' conditions are discussed. Team-based models such as nurse-led ward rounds (NLWRs) have been conceptualized and trialled, with positive results.
Methods: An evidence-based quality improvement pilot project to introduce NLWRs was implemented at a cardiovascular medical-surgical unit in a Singapore tertiary hospital. The JBI Evidence Implementation Framework was used to guide the project. The evidence-based NLWR format incorporated stakeholder feedback on NLWR frequency, preparation, coordination, and content. Baseline and 6-month post-implementation audits were carried out.
Results: The 4 audit criteria improved from baseline, reaching 100% compliance for criteria 1, 2, and 3 associated with interprofessional communication and collaboration. An improvement from baseline (30% to 46.7%) was also observed for criterion 4 on patient involvement during medical ward rounds. Moreover, there were improvements in clinical outcome data such as patient hospitalization length, "best medical therapy" rates, and inpatient complications. A statistically significant improvement in nurses' confidence to lead discussions during medical rounds was also observed ( p = 0.026).
Conclusions: This project promoted greater compliance with NLWR criteria through audit and feedback cycles and the contextualization of implementation strategies. A well-supported program that prepares nurses for interprofessional communication also improves nurses' confidence in team communication, bolstering their ability to provide high-quality patient care.