Structured, nurse-led ward rounds to improve interprofessional communication and optimize care of vascular surgery patients: a best practice implementation project.

IF 2.7 4区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Jbi Evidence Implementation Pub Date : 2023-12-01 DOI:10.1097/XEB.0000000000000385
Nicholas Wee Siong Neo, Yao Li, Ailene Bandoy Salazar, Jessica Kai Lun Gan, Jun Jie Ng, Poh Chi Tho
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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.

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结构化、护士主导的查房,以改善跨专业沟通并优化血管手术患者的护理:一个最佳实践实施项目。
导语:查房是重要的住院活动,在查房期间讨论患者的病情。基于团队的模式,如护士带领的查房(NLWR),已经被概念化并进行了试验,取得了积极的结果。方法:在新加坡一家三级医院的心血管外科实施了一项基于证据的质量改进试点项目,以引入NLWRs。JBI证据实施框架用于指导该项目。基于证据的NLWR格式包含了利益相关者对NLWR频率、准备、协调和内容的反馈。进行了基线审计和实施后6个月的审计。结果:4项审计标准比基线有所改善,达到了与跨专业沟通和协作相关的标准1、2和3的100%合规性。在医疗查房期间,标准4的患者参与度也比基线(30%至46.7%)有所改善。此外,患者住院时间、“最佳药物治疗”率和住院并发症等临床结果数据也有所改善。在医疗查房期间,护士领导讨论的信心也有统计学上的显著提高(p = 0.026)。结论:该项目通过审计和反馈周期以及实施战略的背景化,促进了对NLWR标准的更大遵守。一个支持良好的项目,为护士进行跨专业沟通做好准备,也提高了护士对团队沟通的信心,增强了他们提供高质量患者护理的能力。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
13.00%
发文量
23
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