Neonatal respiratory therapist-led rounds can improve staff satisfaction and timeliness of respiratory interventions.
BACKGROUND
Interdisciplinary rounding is used to establish and communicate patient care goals and monitor progress toward goal attainment. This study describes staff satisfaction and process outcomes associated with respiratory therapist (RT)-led interdisciplinary rounds in the neonatal ICU. We hypothesized improved staff satisfaction, execution of orders within 30 min of order entry into the electronic medical record, and communication of accurate and complete data during rounds to the interdisciplinary team.


METHODS
Nurses, RTs, nurse practitioners, residents, and attending physicians completed the 13-question survey eliciting demographic information and evaluating staff engagement and professional satisfaction. The survey was anonymous and confidential, and informed consent was implied. Process data were collected for a 10-d period at 2 intervals through direct observation of the rounding process and electronic medical record review. Descriptive statistics reported patient demographics, responses to job satisfaction and engagement survey questions, the number of patients who were visited in daily rounds, the number and type of orders given during rounds, and the number of respiratory orders that were addressed in multidisciplinary teaching rounds rather than during respiratory rounds. The chi-square test was used to determine differences in the proportion of inaccurate and incomplete data communicated during rounds between the 2 data collection periods. The Mann-Whitney U test was used to determine differences in the timeliness of electronic medical record order entry and time to order completion.


RESULTS
A 94.8% survey response rate (n = 55) was obtained. Seventy-six percent of participants reported improved communication. Sixty-nine percent of participants reported improved teamwork. Eighty-six percent of orders were implemented immediately after electronic medical record entry. Correct information was provided on 95% and 99.3% of patients (P < .066) and complete information on 93% and 96% of patients (P = .41).


CONCLUSIONS
Implementation of respiratory rounds improved staff satisfaction and the timeliness of completing respiratory orders. Spot monitoring at intermittent intervals verified process sustainability.
Department of Respiratory Care irenegenet@sbcglobal.net.
Irene C
IC
Genet
Neonatal Intensive Care Unit, Akron Children's Hospital, Akron, Ohio.
Kimberly S
KS
Firestone
Department of Respiratory Care.
Teresa A
TA
Volsko
D000328:Adult; D001291:Attitude of Health Personnel; D003422:Critical Care / Q000458:organization & administration*; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000458:organization & administration*; D007588:Job Satisfaction; D008297:Male; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D010348:Patient Care Team / Q000592:standards*; D012124:Respiratory Care Units / Q000458:organization & administration*; D056164:Teaching Rounds / Q000458:organization & administration*
interdisciplinary rounds; neonatal; organizational efficiency; outcome measures; professionalism; quality improvement; teamwork