Improving Nurse Participation in Family-Centered Rounds in General Pediatrics: A Quality Improvement Initiative

Introduction and background Family-centered rounds (FCRs) are the cornerstone of collaborative pediatric inpatient care, promoting communication and shared decision-making among healthcare teams and families. However, active participation by assigned nurses is often inconsistent, which may limit optimal care coordination. Objective This quality improvement (QI) project aimed to enhance assigned nurse attendance during physician-led FCRs of the general pediatric team at a tertiary hospital. Methods A multidisciplinary team utilized a driver diagram to identify key barriers to nurse participation, including scheduling conflicts, unclear expectations, and workflow disruptions. Targeted interventions were introduced over a 10-week period. These included the implementation of a dedicated Doctors-Nurses schedule (DNS), a registrar checklist tool, and recognition strategies to reinforce engagement. Key metrics tracked included nurse attendance, nurses' execution of daily treatment plans, checklist tool compliance, and FCR duration. Results Nurse attendance rose from a baseline level of 0% to 91.3% and 94% during the first two Plan-Do-Study-Act (PDSA) cycles, ultimately reaching 100% by the 10th week. Among participating nurses, 80.8% consistently and completely executed assigned treatment plans. Checklist tool compliance remained high at 100% throughout the project. Importantly, there was no statistically significant change in the average duration of rounds (p-value = 0.529), suggesting that the improvements did not negatively impact workflow efficiency. Conclusion Implementing structured, team-led interventions significantly improved nurse engagement in FCRs. This enhanced interdisciplinary collaboration and communication, contributing to efficient and more effective pediatric inpatient care without prolonging clinical workflow.