Patient safety ward round checklist via an electronic app: implications for harm prevention
Patient safety is a value at the core of modern healthcare. Though awareness in the medical community is growing, implementing systematic approaches similar to those used in other high reliability industries is proving difficult. The aim of this research was twofold, to establish a baseline for patient safety practices on routine ward rounds and to test the feasibility of implementing an electronic patient safety checklist application.
Two research teams were formed; one auditing a medical team to establish a procedural baseline of “usual care” practice and an intervention team concurrently was enforcing the implementation of the checklist. The checklist was comprised of eight standard clinical practice items. The program was conducted over a 2-week period and 1 month later, a retrospective analysis of patient charts was conducted using a global trigger tool to determine variance between the experimental groups. Finally, feedback from the physician participants was considered.
The results demonstrated a statistically significant difference on five variables of a total of 16. The auditing team observed low adherence to patient identification (0.0%), hand decontamination (5.5%), and presence of nurse on ward rounds (6.8%). Physician feedback was generally positive.
The baseline audit demonstrated significant practice bias on daily ward rounds which tended to omit several key-proven patient safety practices such as prompting hand decontamination and obtaining up to date reports from nursing staff. Results of the intervention arm demonstrate the feasibility of using the Checklist App on daily ward rounds.
KeywordsGlobal trigger tool Harm Medical error Patient safety Population and developmental health
We would like to thank all the patients who participated in this program and all the staff in the two medical teams who were subject to such scrutiny for over 2 weeks of the study.
Dr. Colin Doherty planned the study initially, before conferring with Connor Keller, Shane Arsenault, Marcel Lamothe, and Radu Bostan. The study was then led by Connor Keller and Dr. Colin Doherty, with Connor Keller, Shane Arsenault, Marcel Lamothe, and Radu Bostan conducting the study on the medical teams led by Dr. Rory O’Donnell and Dr. Joseph Harbinson at St. James’s Hospital, Dublin. The manuscript was prepared and submitted by Connor Keller, with input principally from Dr. Colin Doherty and Shane Arsenault.
Compliance with ethical standards
The authors declare that they have no competing interests.
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