What steps should be taken to prepare for a ward round?

From the Guidelines

Preparing for a ward round requires a thorough and structured approach to ensure comprehensive patient care and efficient communication with the multidisciplinary team. Begin by reviewing all patient information, including recent test results, medication charts, observation charts, and fluid balance records, as recommended by the BTS guideline for oxygen use in adults in healthcare and emergency settings 1. Gather the necessary equipment such as stethoscope, pen torch, and prescription charts. Create a structured patient list with key details like patient demographics, diagnosis, current medications (including specific doses and frequencies), recent investigation results, and outstanding tasks.

Key Steps in Preparation

• Review patient information, including recent test results and medication charts
• Gather necessary equipment, such as stethoscope and prescription charts
• Create a structured patient list with key details, including demographics and current medications
• Ensure familiarity with each patient's clinical progress, including vital signs trends and any overnight events
• Prepare concise summaries for each patient, highlighting active problems, management plans, and discharge planning

Prioritization and Efficiency

Prioritize patients who are critically ill or need urgent attention, and anticipate potential questions from senior clinicians by reviewing relevant clinical guidelines and treatment protocols, such as those outlined in the chapter on medical procedures for intensive care unit and hospital preparations for an influenza epidemic or mass disaster 1. Consider consolidating assessments and procedures to optimize nursing contact and efficiency, and establish appropriate monitoring for patients, including video monitoring and slave monitors outside the room for vital signs and electrocardiogram.

Clinical Decision-Making

This preparation is essential because ward rounds are time-constrained opportunities for clinical decision-making, and being organized ensures comprehensive patient care, facilitates efficient communication with the multidisciplinary team, and demonstrates professional competence. Additionally, thorough preparation helps identify potential clinical issues before they become emergencies and ensures continuity of care, as emphasized in the BTS guideline for oxygen use in adults in healthcare and emergency settings 1.

From the Research

Preparation for Ward Round

To prepare for a ward round, several steps can be taken:

• Review patient notes, signs and symptoms, physiological parameters, and investigation results 2
• Prepare to interact with patients and their relatives, and to relate medical information back to them, answer queries, and plan future medical management strategies 2
• Ensure that all necessary information is gathered, including medical history, current medications, and laboratory results
• Develop a focused physical examination plan to assess the patient's condition

Key Skills Required

The following skills are essential for a successful ward round:

• Information gathering: ability to collect and interpret relevant patient data 3
• Communication with patients: ability to effectively communicate with patients and their relatives 3
• Focused physical examination: ability to perform a thorough and targeted physical examination 3
• Chart reviewing, prescription, and documentation: ability to accurately review and update patient charts, prescribe medications, and document patient information 3
• Team communication: ability to effectively communicate with other healthcare team members 3

Use of Checklists

The use of a ward round checklist can improve patient perception of care and reduce errors 4

• Checklists can help ensure that all necessary tasks are completed during the ward round
• Checklists can also help to improve documentation and reduce errors

Additional Considerations

Other factors to consider when preparing for a ward round include:

• The need for ongoing education and training to improve ward round skills 3
• The importance of patient-centered care and involving patients in decision-making processes 4
• The need to stay up-to-date with the latest medical research and guidelines, such as those related to oxygen therapy for sepsis 5 and ceftriaxone dosing 6