Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Quality Improvement in the Trauma Intensive Care Unit Using a Rounding Checklist: The Implementation Results

  • Chang, Ye Rim (Department of Surgery, Trauma Center, Dankook University Hospital) ;
  • Chang, Sung Wook (Department of Thoracic and Cardiovascular Surgery, Trauma Center, Dankook University Hospital) ;
  • Kim, Dong Hun (Department of Surgery, Trauma Center, Dankook University Hospital) ;
  • Yun, Jeongseok (Department of Surgery, Trauma Center, Dankook University Hospital) ;
  • Yun, Jung Ho (Department of Neurological Surgery, Trauma Center, Dankook University Hospital) ;
  • Lee, Seok Won (Department of Surgery, Trauma Center, Dankook University Hospital) ;
  • Jo, Han Cheol (Department of Surgery, Trauma Center, Dankook University Hospital) ;
  • Choi, Seok Ho (Department of Surgery, Trauma Center, Dankook University Hospital)
  • Received : 2017.08.22
  • Accepted : 2017.10.12
  • Published : 2017.12.30
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Abstract

Purpose: Despite the numerous protocols and evidence-based guidelines that have been published, application of the therapeutics to eligible patients is limited in clinical settings. Therefore, a rounding checklist was developed to reduce errors of omission and the implementation results were evaluated. Methods: A checklist consisting of 12 components (feeding, analgesia, sedation, thromboembolic prophylaxis, head elevation, stress ulcer prevention, glucose control, pressure sore prevention, removal of catheter, endotracheal tube and respiration, delirium monitoring, and infection control) was recorded by assigned nurses and then scored by the staff for traumatized, critically ill patients who were admitted in the trauma intensive care unit (ICU) of Dankook University Hospital for more than 2 days. A total of 170 patients (950 sheets) between April and October 2016 were divided into 3 periods (period 1, April to June; period 2, July to August; and period 3, September to October) for the analysis. Questionnaires regarding the satisfaction of the nurses were conducted twice during this implementation period. Results: Record omission rates decreased across periods 1, 2, and 3 (19.9%, 12.7%, and 4.2%, respectively). The overall clinical application rate of the checklist increased from 90.1% in period 1 to 93.8% in period 3. Among 776 (81.7%) scored sheets, the rates of full compliance were 30.2%, 46.2%, and 45.1% for periods 1, 2, and 3, respectively. The overall mean score of the questionnaire regarding satisfaction also increased from 61.7 to 67.6 points out of 100 points from period 1 to 3. Conclusions: An ICU rounding checklist could be an effective tool for minimizing the omission of preventative measures and evidence-based therapy for traumatized, critically-ill patients without overburdening nurses. The clinical outcomes of the ICU checklist will be evaluated and reported at an early date.

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References

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