Do ward round stickers improve surgical ward round? A quality improvement project in a high-volume general surgery department

Abstract

IntroductionIncreasing pressure and limitations on the NHS necessitate simple and effective ways for maintaining standards of patient care. This quality improvement project aims to design and implement user-friendly and clear ward round stickers as an adjunct to surgical ward rounds to evidence standardised care.Project design and strategyBaseline performance was measured against the recommended standards by the Royal College of Physicians, General Medical Council and a study performed at the Imperial College London. A total of 16 items were studied. All members of staff in surgery department were informed that an audit on ward round entries would be implemented but exact dates and times were not revealed. In the first cycle, ward round sticker was implemented and results collected across three random days for use and non-use of sticker. Feedback was collected through the use of questionnaires. In the second cycle, the ward round sticker was redesigned based on feedback and results collected for use and non-use of sticker.ResultsBaseline performance noted in 109 ward round entries showed that checking of drug chart, intravenous fluid chart, analgesia, antiemetic, enoxaparin, thromboembolic deterrents ranged from 0% to 6%. With the introduction of ward round stickers in both cycles, there was noticeable improvement from baseline in all items; in ward round entries where stickers were not used, performance was similar to baseline.ConclusionThis quality improvement project showed that the use of stickers as an adjunct to surgical ward round is a simple and effective way of evidencing good practice against recommended standards. Constant efforts need to be made to promote compliance and sustainability. Commitment from all levels of staff are paramount in ensuring standardised patient care without overlooking basic aspects.

Pediatric Surgery Rounding Checklists

“…The labels used in one study were limited to the date of discharge and acknowledgment that the physician had reviewed six aspects of the patient's care: antibiotics, fluid balance, medications, venous thromboembolism prophylaxis, blood tests, and patient observations (Krishnamohan et al, 2019). Another study included these components and others on its labels as well as an area to document any outstanding tests (Ng et al, 2018). A third study, on the other hand, focused solely on documenting the care plan and requirements for discharge (Alamri et al, 2016).…”

“…Another study included these components and others on its labels as well as an area to document any outstanding tests (Ng et al, 2018). A third study, on the other hand, focused solely on documenting the care plan and requirements for discharge (Alamri et al, 2016).…”

Improving the Hip Fracture Surgical Consenting Process: A Single Centre Multi-Cycle Quality Improvement Process

“…Checklists of essential pre-operative tasks have been used to improve the rate of completion of requested jobs (18) and their usage in surgical ward rounds has also been found to improve the quality of documentation (19). It has also been established that checklists can have a significant role in changing cultural practice and improving safety (20) with work by the Safe Surgery Saves Lives Study Group finding that a checklist was associated with concomitant reductions in both rates of death and complications in patients undergoing non-cardiac surgery (21) Stickers have been used as part of a checklist, for documentation of ward rounds and demonstrated to be a simple and effective way of evidencing good practice against recommended standards (22). A quality improvement program in NHS Lanarkshire where the use of ward round stickers was audited found them to be a simple and effective safeguard to ensure basic aspects of care were not missed while maintaining standards (23).…”

Improving the surgical consenting process for patients with acute hip fractures: a pilot quality improvement project

“…Checklists of essential pre-operative tasks have been used to improve the rate of completion of requested jobs (18) and their usage in surgical ward rounds has also been found to improve the quality of documentation (19). It has also been established that checklists can have a signi cant role in changing cultural practice and improving safety (20) with work by the Safe Surgery Saves Lives Study Group nding that a checklist was associated with concomitant reductions in both rates of death and complications in patients undergoing non-cardiac surgery (21) Stickers have been used as part of a checklist, for documentation of ward rounds and demonstrated to be a simple and effective way of evidencing good practice against recommended standards (22). A quality improvement program in NHS Lanarkshire where the use of ward round stickers was audited found them to be a simple and effective safeguard to ensure basic aspects of care were not missed while maintaining standards (23).…”