title: A PICU patient safety checklist: rate of utilization and impact on patient care.
abstract: OBJECTIVE
  In healthcare, checklists help to ensure patients receive evidence-based, safe care. Since 2007, we have used a bedside checklist in our PICU to facilitate daily discussion of care-related questions at each bedside. The primary objective of this study was to assess compliance with checklist use and to assess how often individual checklist elements affected patient management. A secondary objective was to determine whether patient and unit factors (severity of illness, unit census, weekday vs. weekend, admitting diagnosis group) influenced checklist use.
  
  
  METHODS
  This was a prospective observational study. A research assistant attended daily bedside rounds to collect data at each eligible patient encounter.
  
  
  METHODS
  The study was conducted in the Children's Hospital of Eastern Ontario (CHEO) PICU, a 12-bed cardiac and medical-surgical unit.
  
  
  METHODS
  Included all patients admitted to the PICU prior to 6 am and who were not being discharged that day.
  
  
  METHODS
  A bedside rounds checklist.
  
  
  METHODS
  Included compliance and whether the checklist affected the patient's management plan.
  
  
  RESULTS
  A total of 148 encounters were collected on 28 days between September 2013 and February 2014. Compliance with the checklist was 89.2% (132/148; 95% CI 83.2-93.2%) and was not influenced by admitting diagnosis group, patient census, severity of patient's conditions or weekday/weekend status. The checklist affected the patient management plan 52.6% of the time (69/132; 95% CI 44.2-61%).
  
  
  CONCLUSIONS
  Our study found high rates of compliance with an established checklist that has been in use in the PICU since 2007. Checklist use frequently resulted in a change in the patient management plan.
authors.affiliation: PICU, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.
authors.forename: Brianna L
authors.initials: BL
authors.lastname: Mckelvie
authors.affiliation: PICU, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.
authors.forename: James Dayre
authors.initials: JD
authors.lastname: Mcnally
authors.affiliation: PICU, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.
authors.forename: Kusum
authors.initials: K
authors.lastname: Menon
authors.affiliation: PICU, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.
authors.forename: Maelle G R
authors.initials: MG
authors.lastname: Marchand
authors.affiliation: Research Institute, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.
authors.forename: Deepti N
authors.initials: DN
authors.lastname: Reddy
authors.affiliation: PICU, Children's Hospital of Eastern Ontario (CHEO), Ottawa, Canada.
authors.forename: W David
authors.initials: WD
authors.lastname: Creery
mesh_terms: D057189:Checklist / Q000706:statistics & numerical data*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000706:statistics & numerical data*; D009864:Ontario; D010043:Outcome and Process Assessment, Health Care; D061214:Patient Safety / Q000706:statistics & numerical data*; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: best practice guidelines; checklist; intensive care units; patient safety; pediatrics; quality improvement