Project Information

Nurse Integrated Rounds

Project Description: Patient safety reports (PSRs) in the Pediatric Intensive Care Unit (PICU) are routinely evaluated for root causes. Communication failures between medical services, nursing, and ancillary departments most frequently contributed to these events. In an effort to improve communication and hence, patient outcomes, nurse integrated rounds (NIR) were implemented. To improve communication and understanding of the patient’s plan of care among all PICU providers, we implemented nurse integrated rounds, where the bedside nurse “presents” the patient’s clinical status and highlights issues that need to be addressed in the plan of care for the day. The pediatric resident then identifies the strategies to address the patient’s problems in concert with the pediatric critical care fellow and attending. PICU nursing staff completed a pre-survey designed to evaluate their understanding of the patient’s plan of care and their perceptions of the effectiveness of patient rounds and communication with the patient’s care teams. Following the pre-survey, the nursing staff was educated on the use of a rounding sheet and the expectations for the nurse’s presentation during NIR. Six months after the implementation of NIR, nurses completed an abbreviated post-survey regarding the efficiency and effectiveness of NIR and whether the process should continue. Patient safety reports were reviewed for trends related to communication failures. Additionally, the Management Engineering department was consulted to evaluate the PICU daily multidisciplinary rounds process and make suggestions for improvement.

QPI: Jodi, Mullen, (

Collaborators: Jodi, Mullen, (; K, Avery, (; (; Melissa, Reynolds, (


UF Health Big Aims: Reduce Variation None

MeSH Keywords: