CLINICAL QUESTION: What are the benefits and barriers to participating in patient-and-family-centered (PFC) rounds from a pediatric nursing perspective?
BACKGROUND: Interprofessional PFC rounding models, such as I-PASS (illness severity, patient summary, action list, situational awareness, and synthesis by the receiver), have been shown to improve team communication and reduce medical errors and adverse events. Nurse involvement is an essential component of PFC I-PASS rounds. However, the benefits, barriers, and facilitators to nursing engagement have been understudied.
STUDY DESIGN: Qualitative descriptive study
SETTING: Focus groups in 21 U.S. community and tertiary, pediatric, teaching hospitals
SYNOPSIS: This study evaluated the results of four focus groups on the implementation of PFC I-PASS rounds, comprised of 29 bedside nurses from 14 pediatric, tertiary, and community, teaching hospitals. Three themes emerged: benefits, barriers, and facilitators. Benefits included improved communication, advocacy for patients or families, efficiency, and identifying nurses as important team members. Barriers included nurses’ workload demands, a lack of consistency among medical teams performing PFC I-PASS rounds, uncertainty about whether nurses are part of the medical team, and families’ availability during rounds. Finally, facilitators included a clearly defined role for nurses on rounds, strategies to increase nursing presence on rounds, predictable rounding times, attending physicians who modeled an inclusive whole-team environment, and expectations set with families about participation during rounds. Limitations of this study are a lack of description of participant demographics and career experience, and that not all sites in the original PFC I-PASS study are represented. While patients’ or families’ and physicians’ perspectives of PFC I-PASS rounds have been described, this study focuses on the perspectives of nurses who have a clearly identified role in PFC I-PASS rounds.
BOTTOM LINE: Nurses report benefits, barriers, and facilitators to the implementation of PFC I-PASS rounds; however, their perspective on the uncertainty of the importance of their role in PFC rounds and how to eliminate barriers should be explored
CITATION: Baird J, et al. Pediatric nurse perspectives on patient- and family-centered rounds: a qualitative study. J Hosp Med. 2025;20(11):1166- 1173. doi: 10.1002/jhm.70071.
Dr. Grace
Dr. Grace is a med-peds hospitalist in the departments of internal medicine and pediatrics at The Ohio State University Wexner Medical Center and Nationwide Children’s Hospital and an assistant professor of medicine at The Ohio State University College of Medicine, all in Columbus, Ohio.
Dr. Sprauer
Dr. Sprauer is a med-peds-trained pediatric hospital medicine fellow at Nationwide Children’s Hospital in Columbus, Ohio.