Kiffin R Smallegan, Samantha J Smith, Heather L Wilder, Gabriylle E Payne, Sorana Raiciulescu, Carolyn M Capps
{"title":"重新设计重症监护病房查房以改善军队医院的协作。","authors":"Kiffin R Smallegan, Samantha J Smith, Heather L Wilder, Gabriylle E Payne, Sorana Raiciulescu, Carolyn M Capps","doi":"10.4037/ccn2025757","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Team communication is essential to delivering health care safely. Nurses in the adult intensive care unit at a large military treatment facility were not consistently present in daily patient rounds and stated that team communication could be improved. This clinical question was developed: among critical care staff members, how does a standardized daily rounding script, compared with current practice, impact interdisciplinary communication over a 36-week period?</p><p><strong>Review of evidence: </strong>Current literature includes 3 themes: rounds should be interdisciplinary; include the ABCDEF bundle (pain assessment, spontaneous awakening and breathing trials, analgesia and sedation choice, delirium assessment, early mobility, and family engagement); and use a standardized script. These elements can improve perceptions of collaboration in rounds.</p><p><strong>Implementation: </strong>An interdisciplinary rounding script was introduced across 2 adult intensive care units at a military hospital over 36 weeks. Before and after the intervention, the Collaboration and Satisfaction About Care Decisions survey was used to assess nurses' perceptions of collaboration; rounds were observed for key elements.</p><p><strong>Evaluation: </strong>After implementation, the mean survey score (both units combined) rose by 1.5 units, nurse presence at rounds increased by 21.6% (P = .01), nurse contributions to rounds increased by 31.1% (P = .001), all bundle elements were reviewed 18.9% more often (P = .07), a summary of care was given 53.6% more often (P < .001), and order read back was completed 69.8% more often (P < .001).</p><p><strong>Sustainability: </strong>Continued use of the script in the military treatment facility will require adapting it to practice changes and training new staff members on its use.</p>","PeriodicalId":10738,"journal":{"name":"Critical care nurse","volume":"45 5","pages":"16-26"},"PeriodicalIF":2.0000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Redesigning Intensive Care Unit Rounds to Improve Collaboration at a Military Hospital.\",\"authors\":\"Kiffin R Smallegan, Samantha J Smith, Heather L Wilder, Gabriylle E Payne, Sorana Raiciulescu, Carolyn M Capps\",\"doi\":\"10.4037/ccn2025757\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Team communication is essential to delivering health care safely. Nurses in the adult intensive care unit at a large military treatment facility were not consistently present in daily patient rounds and stated that team communication could be improved. This clinical question was developed: among critical care staff members, how does a standardized daily rounding script, compared with current practice, impact interdisciplinary communication over a 36-week period?</p><p><strong>Review of evidence: </strong>Current literature includes 3 themes: rounds should be interdisciplinary; include the ABCDEF bundle (pain assessment, spontaneous awakening and breathing trials, analgesia and sedation choice, delirium assessment, early mobility, and family engagement); and use a standardized script. These elements can improve perceptions of collaboration in rounds.</p><p><strong>Implementation: </strong>An interdisciplinary rounding script was introduced across 2 adult intensive care units at a military hospital over 36 weeks. 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Redesigning Intensive Care Unit Rounds to Improve Collaboration at a Military Hospital.
Background: Team communication is essential to delivering health care safely. Nurses in the adult intensive care unit at a large military treatment facility were not consistently present in daily patient rounds and stated that team communication could be improved. This clinical question was developed: among critical care staff members, how does a standardized daily rounding script, compared with current practice, impact interdisciplinary communication over a 36-week period?
Review of evidence: Current literature includes 3 themes: rounds should be interdisciplinary; include the ABCDEF bundle (pain assessment, spontaneous awakening and breathing trials, analgesia and sedation choice, delirium assessment, early mobility, and family engagement); and use a standardized script. These elements can improve perceptions of collaboration in rounds.
Implementation: An interdisciplinary rounding script was introduced across 2 adult intensive care units at a military hospital over 36 weeks. Before and after the intervention, the Collaboration and Satisfaction About Care Decisions survey was used to assess nurses' perceptions of collaboration; rounds were observed for key elements.
Evaluation: After implementation, the mean survey score (both units combined) rose by 1.5 units, nurse presence at rounds increased by 21.6% (P = .01), nurse contributions to rounds increased by 31.1% (P = .001), all bundle elements were reviewed 18.9% more often (P = .07), a summary of care was given 53.6% more often (P < .001), and order read back was completed 69.8% more often (P < .001).
Sustainability: Continued use of the script in the military treatment facility will require adapting it to practice changes and training new staff members on its use.
期刊介绍:
Critical Care Nurse (CCN) is an official publication of the American Association of Critical-Care Nurses (AACN). Authors are invited to submit manuscripts for consideration and peer review. Clinical topics must meet the mission of CCN and address nursing practice of acute and critically ill patients.