Pediatric Surgery Rounding Checklists

Abstract

Background Inpatient surgical teams are challenged with treating complex patients, communicating across disciplines, educating trainees, and transitioning between the operating room, clinic, and inpatient unit. Systematic approaches to rounds are needed to perform these tasks effectively. Prior studies on nonsurgical units have shown that rounding checklists improve patient safety and trainee education. However, few studies have investigated the utility of checklists on surgical rounds. Objective The purpose of this article is to synthesize the evidence regarding rounding checklists on inpatient surgical units, with a focus on structure, content, utilization, outcomes, and educational value. Methods A narrative review was completed after a search of PubMed, Embase, and Cumulative Index of Nursing and Allied Health Literature in November 2020 using the following index terms and keywords: pediatrics, operative surgical procedures, surgery, perioperative period, teaching rounds, rounds, checklist, rounding tool, and rounding list. Results We identified 11 relevant studies. Six were conducted on inpatient surgical units (54%), and five were conducted on medicine or critical care units (46%). The structure and content of checklists were varied, with most integrating subjective and objective findings. These studies show that rounding checklists improve the organization and completeness of rounds, interdisciplinary communication, documentation, adverse event rates, and educational opportunities. However, they also increase rounding time and require reinforcement for sustained compliance. Conclusions The existing literature suggests rounding checklists can help create a culture of safety in which every team member, from nurse to attending, actively participates in improving patient care. We provide strategies to develop rounding checklists for pediatric surgical units.