Date of Award

January 2018

Document Type

Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Ruth McCorkle

Second Advisor

Martha Swartz

Abstract

Implementation of bedside rounds enhances communication and collaboration between physicians and nurses, resulting in improved clinical outcomes. Yet, the literature demonstrates that it remains difficult for nurses to attend rounds if they don't know when they are happening. This project aimed to: increase nurses' presence, participation and contribution at bedside rounds in a pediatric acute care unit, enhance clinical teamwork and collaboration, and improve quality outcomes. Nurses carried a pager so that physicians could alert them of rounds. Perception of teamwork and collaboration was assessed via surveys pre- and post- intervention as well as the National Database of Nursing Quality Indicators (NDNQI )'s annual survery evaluating RN and MD interactions. Other quality outcome measures included length of stay and patient satisfaction through Press GaneyTM surveys. Findings demonstrated that when nurses were notified in advance, their participation in rounds increased from 44.4 to 73%. Length of stay decreased from 2.5 days prior to the project to an average of 2.10 during the project. Scores on inpatient satisfaction surveys increased from 82.4 to 92.2%, and nursing communication improved from 83.3 to 95.65%. Interprofessional collaboration as reflected by the inclusion of nurses at bedside rounds led to positive outcomes in patient care. Increasing nurses' presence and providing them with a role in patient care rounds is an important step towards fostering teamwork and collaboration with physicians and enhancing family-centered care in a pediatric inpatient setting. Further research measuring the impact of interprofessional collaboration in healthcare is needed.

Comments

This thesis is restricted to Yale network users only. It will be made publicly available on 09/03/2019

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