Quality Improvement Project: Rounding Checklist to Improve Nutritional Management in the Intensive Care Unit

Abstract

Purpose: This DNP project is a quality improvement initiative focused on improving interprofessional communication and collaboration in the care of critically ill adult patients. The primary objective is to adopt an evidence-based nutrition checklist to assess each patient's nutritional status during multidisciplinary rounds.Background: Adequate nutrition in the critically ill patient population is imperative yet frequently disregarded by healthcare staff. Malnutrition is linked to an increased risk of mortality, length of stay, readmission, and cost. Researchers have found that supporting critically ill patients' nutritional requirements can lead to improvements in patient outcomes and a reduction in mortality. Methods: Design: This quality improvement project is two-fold. Part one included an educational PowerPoint with pre-and post-surveys. Secondly, participation as a Nutrition Checklist Champion was reserved for dayshift RNs, similarly including pre-and post-surveys. Setting: The 30-bed intensive care unit (ICU) at Mayo Clinic Hospital, a 268-bed academic tertiary care hospital in Phoenix, Arizona Participants: Participants included critical care nurses. Participation was voluntary. A total of 16 RNs volunteered to participate in the education portion of the project, and a total of 11 RNs volunteered to participate as Nutrition Checklist Champions. Measurements: Adoption of checklists into practice measured as a compliance rate. Additionally, pre- and post-implementation surveys in Likert scale format are intended to assess the current state and any perceived improvements in communication, collaboration, and knowledge of the nutritional plan of care. Descriptive and inferential statistics were used to compare and analyze each Likert item. Results: Overall, this quality improvement project achieved its objectives and found that the implementation of the Nutrition Checklist led to an improvement in collaboration and communication of nutrition-related goals, a more consistent and comprehensive approach to goal planning, a structured and individualized approach to goal creation, and improved knowledge of nutritional management. Conclusions: Effective communication and collaboration between healthcare providers are essential to delivering high-quality collaborative care. Based on the results of this project, the adoption of the Nutrition Checklist is feasible and can improve communication and knowledge of the plan of care.