Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

4-17-2017

Graduate Advisor

Susan Dean-Baar

Co-Advisor

Ericka Sanner-Stiehr

Committee

Cynthia Brooks

Abstract

Background

Multiple industries have demonstrated checklists to be of great value in reducing errors of omission and improving communication. In healthcare, checklists have been shown to ensure patients receive evidence-based, safe care. In a fast paced environment of a critical care unit, adverse events are common and can have significant consequences on patient outcome. Safety guardrails are necessary to minimize naturally occurring human error. Safety checklists help support best practices to standardize care and support processes to improve outcome.

Objectives

To develop and implement a daily safety checklist in a pediatric intensive care unit (PICU) to enhance clinical care and improve patient outcome.

Methods

After an extensive review of the literature , a multidisciplinary team was created to determine the structure and content for the checklist then placed on an electronic device. The setting of a 30-bed pediatric intensive care unit (PICU) in an urban academic institution was chosen. The PICU nurse practitioner team was identified as the data collection team. Pre and post-implementation surveys regarding perceptions of benefit of the checklist were administered to the data collection team.

Results

A total of 447 checklists were completed in thirty days. Data was successfully captured, and a reporting system was established. Results of the checklist were communicated with the multidisciplinary team daily. Surveyed practitioners reported an improved perception of the benefits of the checklist including improved team communication, improved outcomes, identification of safety issues, and the importance of the role in safety after implementation.

Conclusion

The use of a daily safety checklist in a pediatric critical care unit has the potential to enhance clinical care and improve patient outcome. Multidisciplinary communication, enhanced awareness of safety, and improved team perception of value can be improved from collaborative efforts to improve safety in a high paced critical care environment.

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