Abstract
Objective To systematically evaluate the effect of bedside ward round checklists on the clinical outcomes of critical patients and thus provide a scientific and rational basis for decision-making in its clinical application. Methods PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang databases were searched to collect the literature studies about randomized controlled trials (RCTs) and cohort studies involving the effect of bedside ward round checklists on the clinical outcomes of critical patients, and the retrieval time limit was from the establishment of the database to August 2019. After two researchers independently screened the literature studies, extracted the literature data, and evaluated the risk of bias in included studies, meta-analysis was carried out by using Stata 12.0 software. Results Two RCTs and nine cohort studies were included in this study. The results of meta-analysis showed that compared with the ordinary bedside ward round, the application of checklist in bedside ward round could shorten the ICU hospitalization time (standardized mean difference (SMD) = – 0.37, 95% CI (– 0.78, 0.04), P ≤ 0.001) and mechanical ventilation time (SMD = – 0.24, 95% CI (– 0.44, −0.04), P = 0.037) and reduce the incidence of ventilator-associated pneumonia (VAP) (SMD = 0.61, 95% CI (0.38, 0.99), P = 0.057) in critical patients. However, there were no significant differences in central venous catheter (CVC) retention time and incidence and mortality of deep venous thrombosis (DVT) between ordinary ward round and bedside ward round checklist. Conclusion The existing evidence shows that compared with the ordinary ward round, the application of bedside ward round checklists can shorten ICU hospitalization time and mechanical ventilation time and reduce VAP incidence and ICU mortality in critical patients. However, due to the limitations of the quality of the included studies, the above conclusions need to be verified with more high-quality studies.
Highlights
Two randomized controlled trials (RCTs) and nine cohort studies were included in this study. e results of meta-analysis showed that compared with the ordinary bedside ward round, the application of checklist in bedside ward round could shorten the ICU hospitalization time (standardized mean difference (SMD) – 0.37, 95% CI (– 0.78, 0.04), P ≤ 0.001) and mechanical ventilation time (SMD – 0.24, 95% CI (– 0.44, −0.04), P 0.037) and reduce the incidence of ventilatorassociated pneumonia (VAP) (SMD 0.61, 95% CI (0.38, 0.99), P 0.057) in critical patients
PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang databases were searched to collect the literature studies about randomized controlled trials (RCTs) and cohort studies involving the effect of bedside ward rounds on the clinical outcomes of critical patients, and the retrieval time limit was from the establishment of the database to August 2019. e retrieval was carried out by combining subject words with free words
1 ere was population representativeness in the cohort group; 2 the samples in the control group were from the same population as those in the cohort group; 3 the methods were used for determining exposure factors; 4 there were no outcome indicators to be observed at the beginning of the study; 5 the most important confounding factors were controlled in the study; 6 other confounding factors were controlled in the study; 7 evaluation of outcomes: whether the scoring of the results was sufficient in the study; 8 whether the follow-up time was long enough; and 9 whether the follow-up in the cohort group and the control group was sufficient
Summary
The checklist can improve the compliance of medical staff to clinical practice standards and reduce the incidence of adverse events in process management [8], previous studies at home and abroad showed that the bedside ward round checklists, which are not designed solely based on evidences, have no unified standard for the feasibility and effectiveness. Journal of Healthcare Engineering of their examination items It is still controversial whether the application of bedside ward round checklists can improve the clinical outcome of critical patients, and currently, there is no comprehensive systematic evaluation. Is study systematically evaluated the effect of bedside ward round checklists on the clinical outcome of critical patients, assessed the decision-making information needs of critical patients on bedside ward rounds, and further explored the timing and process management for the application of ICU bedside ward round checklists, so as to provide a decisionmaking basis for clinical evidence-based practice in the future
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