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"Safety by DEFAULT": introduction and impact of a paediatric ward round checklist

Peters, MJ; Sharma,, S; (2013) "Safety by DEFAULT": introduction and impact of a paediatric ward round checklist. Critical Care , 17 (5) , Article R232. 10.1186/cc13055. Green open access

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Abstract

Introduction Poor communication is a source of risk. This can be particularly significant in areas of high clinical acuity such as intensive care. Ward rounds are points where large amounts of information must be communicated in a time-limited environment with many competing interests. This has the potential to reduce effective communication and risk patient safety. Checklists have been used in many industries to improve communication and mitigate risk. We describe the introduction of a ward round safety checklist 'DEFAULT' on a paediatric intensive care unit. Methods A non-blinded, pre- and post-intervention observational study was undertaken in a 12 bedded Level 3 tertiary PICU between July 2009 and December 2011. Results Ward round stakeholders subjectively liked the checklist and felt it improved communication. Introduction of the ward round checklist was associated with an increase in median days between accidental extubations from 14 (range 2--86) to 150 (56 -- 365) (Mann Whitney p < 0.0001). The ward round checklist was also associated with an increase in the proportion of invasively ventilated patients with target tidal volumes of <8ml/kg which fell from 35 of 71 patients at 08.00 representing a proportion of 0.49 (95%CI 0.38--0.60) to 23 of 38 (0.61, 0.45--0.74). This represented a trend towards an increased proportion of cases in the target range (z = 1.68, p = 0.09). Conclusions The introduction of a ward round safety checklist was associated with improved communication and patient safety.

Type: Article
Title: "Safety by DEFAULT": introduction and impact of a paediatric ward round checklist
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/cc13055
Publisher version: http://dx.doi.org/10.1186/cc13055
Language: English
Additional information: © 2013 Sharma et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Infection, Immunity and Inflammation Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1410386
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