Systematic Evaluation of the Effect of Bedside Ward Round Checklist on Clinical Outcomes of Critical Patients

Abstract

Objective. To systematically evaluate the effect of bedside ward round checklists on the clinical outcomes of critical patients and thus provide a scientific and rational basis for decision-making in its clinical application. Methods. PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang databases were searched to collect the literature studies about randomized controlled trials (RCTs) and cohort studies involving the effect of bedside ward round checklists on the clinical outcomes of critical patients, and the retrieval time limit was from the establishment of the database to August 2019. After two researchers independently screened the literature studies, extracted the literature data, and evaluated the risk of bias in included studies, meta-analysis was carried out by using Stata 12.0 software. Results. Two RCTs and nine cohort studies were included in this study. The results of meta-analysis showed that compared with the ordinary bedside ward round, the application of checklist in bedside ward round could shorten the ICU hospitalization time (standardized mean difference (SMD) = – 0.37, 95% CI (– 0.78, 0.04), P ≤ 0.001) and mechanical ventilation time (SMD = – 0.24, 95% CI (– 0.44, −0.04), P = 0.037) and reduce the incidence of ventilator-associated pneumonia (VAP) (SMD = 0.61, 95% CI (0.38, 0.99), P = 0.057) in critical patients. However, there were no significant differences in central venous catheter (CVC) retention time and incidence and mortality of deep venous thrombosis (DVT) between ordinary ward round and bedside ward round checklist. Conclusion. The existing evidence shows that compared with the ordinary ward round, the application of bedside ward round checklists can shorten ICU hospitalization time and mechanical ventilation time and reduce VAP incidence and ICU mortality in critical patients. However, due to the limitations of the quality of the included studies, the above conclusions need to be verified with more high-quality studies.

The use of checklists in the intensive care unit: a scoping review

“…The systematic reviews on the ICDSC, a delirium screening checklist, were supportive of its use following the assessment of its validity [9,[42][43][44][45][46]. One systematic review on bedside ward round checklists found significant improvements in ICU length of stay (ICU LOS) and mechanical ventilation (MV) duration which were also the two most improved clinical outcomes identified by our scoping review [47]. The systematic reviews on handover checklists affirmed the improvements in information transfer and omissions found in our review [48].…”

“…To our knowledge, this is the first published scoping review on the use and efficacy of checklists within the ICU but other reviews on related topics have previously been published [9,10,[41][42][43][44][45][46][47][48][49]. We identified one other scoping review on quality improvement tools for the nursing care of long stay patients in the ICU [41].…”

“…We identified one other scoping review on quality improvement tools for the nursing care of long stay patients in the ICU [41]. Ten systematic reviews on specific checklists have been published since 2012 [9,10,[42][43][44][45][46][47][48][49]. Six of the systematic reviews analysed delirium screening checklists specifically and one was published for each of the other four checklist types we identified.…”

Improving Thoracic Surgery Ward Round Quality and Enhancing Patient Safety in a referral centre

“…We based this implementation in several papers that have been published reinforcing the value of checklists during ward rounds. Wen et al investigated the role of these and concluded that the checklist can be used to quickly identify the focus of quality inspection and could reduce the incidence of unexpected adverse events (17). Speci cally, another study concluded that checklist-based prompting improved multiple processes of care, including reported improvement in mortality and length of stay in their cohort, reducing errors of omission.…”

Improving Thoracic Surgery Ward Round Quality and Enhancing Patient Safety in a Referral Centre

“…We based this implementation on several papers that have been published reinforcing the value of checklists during ward rounds. Wen et al investigated the role of these and concluded that the checklist can be used to quickly identify the focus of quality inspection and could reduce the incidence of unexpected adverse events [ 17 ]. Specifically, another study concluded that checklist-based prompting improved multiple processes of care, including reported improvement in mortality and LOS in their cohort, reducing errors of omission.…”