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An Implementation Science Approach to Promote Bedside Interprofessional Rounding
Elizabeth Riley1, Sara E Peeples, Misty Williams
1Author Affiliations: College of Nursing, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Drs Riley, Reeves, and Schay); Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr Peeples); Women Infant Service Line Neonatal Intensive Care Unit, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Williams); Division of Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio (Dr Nienaber); and College of Pharmacy and Center for Implementation Research, University of Arkansas for Medical Sciences, Little Rock, Arkansas (Dr Curran).
Background:
Lack of interprofessional communication in the neonatal intensive care unit (NICU) can result in delayed treatments, misdiagnoses, medication errors, patient injuries, and/or death. One approach to facilitate effective communication between team members and caregivers is the use of bedside interprofessional rounding (BIPR).
Purpose:
The purpose of this project was to standardize and increase BIPR participation with an implementation science approach. Secondary goals included measuring the impact of BIPR on central line dwell time and patient length of stay (LOS).
Methods:
The implementation of a BIPR checklist in the electronic health record (EHR), supported by other implementation strategies (eg, Situation, Background, Assessment, Recommendations reporting tool, staff education, audit & feedback, and leadership engagement), was utilized to standardize rounding. Pre- and post-implementation data were analyzed for BIPR usage and quality metrics related to central line dwell time and patient LOS.
Results:
On average, the BIPR checklist was utilized 87% during the first 6 months of deployment, with fluctuation in the weekly/monthly usage due to rounding team schedules. The BIPR checklist led to a 10.5% increase in nurse participation during rounds, 15 hours less average central line dwell time, and standardization of the rounding process as reported by team members, and no difference in LOS.
Implications For Practice/Research:
NICUs can individualize BIPR using implementation science strategies to enhance rounding standardization and improve specific neonatal outcomes. Based on these findings, tools to standardize and promote BIPR, along with staff education, audit & feedback, and leadership support, may benefit NICUs.
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