Article type
Abstract
Background: Ward rounds are essential inpatient activities during which patients’ conditions are discussed. Team-based models such as nurse-led ward rounds (NLWRs) have been conceptualized and trialed, showing positive results in reducing inpatient length of stay (LOS) and adverse events. Patients with vascular disease are associated with complex comorbidities and require multifaceted approach. At a cardiovascular unit, a point-of-prevalence survey found that vascular surgery patients had longer hospitalization as compared to other patients in the unit, averaging 11.7 days.
Objectives: This project aims to implement a NLWR intervention for vascular surgery patients in a cardiovascular medical-surgical unit to optimize care.
Methods: The implementation of NLWR was guided by the JBI Evidence Implementation Framework. Baseline and 6-month post-implementation audits were conducted to evaluate process and clinical outcomes. The NLWR was constructed and refined using an audit and feedback strategy.
Results: A total of 30 nurses were audited on their compliance with the NLWR process. The results showed 100% improvement in three criteria on discussing patients’ needs and condition, care plans and goals, and nurses’ participation (Figure 1). Nurses also took on a more active role and invited patients to raise their questions or concerns during ward rounds (Criterion 4). This resulted in a 16.7% improvement in patient engagement rates.
There is also a reduction in the LOS from 11.7 days to 10.8 days, and inpatient complications from 1 patient to 0 patient. Furthermore, the result showed an improvement in ‘best medical therapy’ rates from 94.1% to 100%. The project team incorporated stakeholders’ feedback from Getting Research into Practice (GRiP) sessions, refining the NLWR intervention’s frequency, preparation, coordination, and content (Table 1).
Conclusion: The implementation of NLWR improved clinical outcomes of vascular surgery patients who require complex care. The collaboration between the multi-disciplinary healthcare professionals enhanced the interprofessional communication to provide high quality patient care.
Objectives: This project aims to implement a NLWR intervention for vascular surgery patients in a cardiovascular medical-surgical unit to optimize care.
Methods: The implementation of NLWR was guided by the JBI Evidence Implementation Framework. Baseline and 6-month post-implementation audits were conducted to evaluate process and clinical outcomes. The NLWR was constructed and refined using an audit and feedback strategy.
Results: A total of 30 nurses were audited on their compliance with the NLWR process. The results showed 100% improvement in three criteria on discussing patients’ needs and condition, care plans and goals, and nurses’ participation (Figure 1). Nurses also took on a more active role and invited patients to raise their questions or concerns during ward rounds (Criterion 4). This resulted in a 16.7% improvement in patient engagement rates.
There is also a reduction in the LOS from 11.7 days to 10.8 days, and inpatient complications from 1 patient to 0 patient. Furthermore, the result showed an improvement in ‘best medical therapy’ rates from 94.1% to 100%. The project team incorporated stakeholders’ feedback from Getting Research into Practice (GRiP) sessions, refining the NLWR intervention’s frequency, preparation, coordination, and content (Table 1).
Conclusion: The implementation of NLWR improved clinical outcomes of vascular surgery patients who require complex care. The collaboration between the multi-disciplinary healthcare professionals enhanced the interprofessional communication to provide high quality patient care.