Evidence-based Practice in Action: Ensuring Quality of Pediatric Assessment Frequency

Optimal frequency of head-to-toe assessment in hospitalized pediatric patients is unknown. An alteration in head-to-toe assessment frequency was proposed at a Midwestern regional hospital. The purpose of this descriptive study was to evaluate patient safety and staff satisfaction following a change in head-to-toe assessment frequency. Method: Chart audits were performed on all patients upon discharge and after any change in level of care to assess the risk to patient safety following the change in head-to-toe assessment frequency. Nurses were surveyed to determine satisfaction with the change. Results: A total of 421 patients were included in the study. After the change, there was no increase in the number of unplanned transfers to the intensive care unit from the previous year. Registered nurses (N=15) perceivedno decrease in patient safety following the change. Registered nurses were satisfied with the change in assessment frequency noting they perceived more time to provide direct patient care. Conclusions: The change in head-to-toe assessment frequency did not impact patient safety, but had a positive impact on nurse satisfaction. Following the study period, the unit policy was changed to reflect the new evidence based head-to-toe assessment interval. Further research is needed with a larger, more diverse sample of pediatric patients and pediatric nurses. (C) 2017 Elsevier Inc. All rights reserved.