Date Available

4-26-2023

Year of Publication

2023

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Jean Edward

Clinical Mentor

Dr. Lindsey Hall

Committee Member

Dr. Karen Butler

Abstract

Research has shown a multidisciplinary rounding approach can improve patient care outcomes in the intensive care unit (ICU). Due to the complexity and wide range of the healthcare team, many patient details and treatment goals may be overlooked during daily patient rounds without a daily goals checklist to help ensure collaboration and communication of the multidisciplinary team. A nurse led daily goals checklist could be useful for framing nurse-provider conversations to promote comprehensive communication and collaboration. The purpose of this project was to improve adherence to a nurse-led daily goals checklist to improve communication and collaboration between the nurses and providers ultimately improving the rates of hospital acquired infections (catheter associated urinary tract infections and central line associated bloodstream infections) and ICU length of stay. This quasi-experimental study utilizes a one group pretest-posttest design to assess the effect of a daily goals checklist on the communication and collaboration of the multidisciplinary healthcare team in a 30-bed medical ICU at a rural tertiary care hospital. A retrospective review was completed to assess the impact on hospital acquired infections and ICU length of stay. A pre-survey was completed by nurses (n=42) and providers (n=8) to assess their views on the status of the communication and collaboration in the ICU. A daily checklist was completed by the bedside nurses to facilitate and organize the multidisciplinary rounds (MDR) for an 8-week implementation period. A post-survey was completed by nurses (n=42) and providers (n=8). The nurse-led daily goals checklist improved communication and collaboration between the nurses and providers in the ICU. Checklist utilization increased throughout the implementation period. Nurses and providers believe the checklist to be beneficial in the ICU and most stated that they will continue to utilize the checklist beyond the project period. Effect on hospital associated infections and length of stay was unable to be determined. The findings of this study indicate that the use of a nurse-led daily goals checklist by the bedside nurse in the ICU may be useful in aiding the communication and collaboration of the multidisciplinary healthcare team during MDR. Finally, the average ICU LOS and number of catheter- associated infections were not significantly changed after the implementation of a nurse-led daily goals checklist. For future practice, integrating the checklist to the electronic medical record could be beneficial for greater buy-in and utilization.

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