Nowacki Katherine, Gonzalez Tondeleyo, Mehnert Jennifer, Jacquemard Amy, Tyler Amy
Children's Hospital Colorado, Aurora, Colorado; and
Departments of Quality and Patient Safety and.
Hosp Pediatr. 2018 Jun;8(6):345-352. doi: 10.1542/hpeds.2017-0174. Epub 2018 May 17.
Whiteboards are a valuable tool used to facilitate communication between families and the care team, but they were underused in our institution. Our aim was to increase families' knowledge of their child's plan of care, safety plan, and medical care team names by increasing the use of patient whiteboards with inpatient populations at a freestanding quaternary care children's hospital.
With this quality improvement study, we redesigned the whiteboard template to address the following 4 main barriers to use: (1) not having enough space to explain concepts to families, (2) having too much information to complete, (3) unclear roles of who completes the whiteboard, and (4) forgetting to update the whiteboard. We focused the content of the new template on critical information the family needed to know, assigned roles to make it easy to know who filled out which section, and used plain language.
The use of each whiteboard section on the old templates ( = 92) versus new templates ( = 424) were compared. Use increased for all sections (plan of care [48.9% to 71.6%; = .008], safety plan [4.3% to 22.8%; ≤ .001], medical team [85.8% to 87.6%; = .068], nurse's name [94.5% to 98.8%; = .031]). After the template redesign, 85.8% of families knew the plan of care, 32.3% knew the safety plan, 61.5% knew the medical team's name, and 92.8% knew the nurse's name.
After the implementation of a new whiteboard template, we significantly increased the use of patient whiteboards and demonstrated improvement in families' knowledge of the plan of care with inpatient populations at a freestanding quaternary care children's hospital.
白板是促进家庭与护理团队沟通的重要工具,但在我们机构中未得到充分利用。我们的目标是通过在一家独立的四级儿童专科医院增加住院患者使用患者白板的频率,提高家庭对其孩子护理计划、安全计划和医疗护理团队成员姓名的了解。
在这项质量改进研究中,我们重新设计了白板模板,以解决以下4个主要使用障碍:(1)没有足够空间向家庭解释概念;(2)要填写的信息过多;(3)不清楚谁来填写白板;(4)忘记更新白板。我们将新模板的内容聚焦于家庭需要了解的关键信息,明确分工以便清楚知道谁填写哪一部分,并使用通俗易懂的语言。
比较了旧模板(n = 92)和新模板(n = 424)各白板部分的使用情况。所有部分的使用频率均有所增加(护理计划[从48.9%增至71.6%;P = .008]、安全计划[从4.3%增至22.8%;P≤.001]、医疗团队[从85.8%增至87.6%;P = .068]、护士姓名[从94.5%增至98.8%;P = .031])。模板重新设计后,85.8%的家庭了解护理计划,32.3%的家庭了解安全计划,61.5%的家庭了解医疗团队成员姓名,92.8%的家庭了解护士姓名。
在实施新的白板模板后,我们显著提高了患者白板的使用频率,并证明在一家独立的四级儿童专科医院,住院患者家庭对护理计划的了解有所改善。