The use of a daily goals sheet to improve communication in the paediatric intensive care unit

Objective: To assess the impact of the implementation of a daily goals sheet upon nursing perception of communication in an academic, tertiary care paediatric intensive care unit (PICU). Design: Prospective, longitudinal, before-and-after intervention surveys. Setting: University affiliated 12-bed PICU. Subjects: Bedside nurses. Interventions: A questionnaire was administered to PICU nurses addressing their perception of communication. Following this questionnaire, the use of a daily goals sheet was instituted. A second questionnaire was administered one year later. Mann-Whitney Rank Sum Test was used to compare differences of the graded outcome variables. Measurements and main results: The primary outcome was the perception of communication taken from a nursing perspective. Eighty-five percent of nurses felt the daily goals sheet led to improved communication between physicians and nurses in the PICU. All questions related to communication demonstrated a positive influence of the goals sheet, with the perception of the PICU staff working as a team reaching statistical significance (p = 0.05). The perception of the care of one surgical service being attending physician directed also significantly improved after the institution of the goals sheet (p = 0.04). Conclusion: The institution of a daily goals sheet led to an improvement in nursing perception of communication. Future studies are required to determine if this change in process has a demonstrable effect on health care outcomes of critically ill children, or whether this tool can have the same beneficial effects in other academic and non-academic PICUs.