INTRODUCTION: The Royal College of Physicians (RCP) and the Royal College of Nursing (RCN) in the United Kingdom advocate the use of structured multidisciplinary team (MDT) ward rounds since they can enable safe, effective, improved care and enhanced staff satisfaction. OBJECTIVES: This project sought to implement best practices for MDT ward rounds in a male medical ward in a hospital in Malawi. METHODS: The project was conducted in line with the JBI Evidence Implementation Framework. A baseline audit of MDT ward rounds was conducted with six staff members. Audit criteria consisted of ten best practices, as recommended by JBI, the RCP, and the RCN. Stakeholder meetings were held to review the baseline audit results and highlight areas of non-compliance. JBI's Getting Research into Practice (GRiP) tool was used to identify barriers to compliance with best practices, and a follow-up audit was conducted to determine changes in practice. RESULTS: The results only showed improvement for one criterion, which rose from 33% to 100% (n=6) where nurses attended the ward round. CONCLUSIONS: This study demonstrated some challenges in evidence implementation projects and how these can, in part, be overcome. While the results only demonstrated improvement for one criterion, this paper shows how audits can be used to promote best practice, which in this case resulted in nurses being more involved in ward rounds, improvements in MDT communication, enhanced nurse inclusion in decision-making and, consequently, patient care. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A233.

Center of Evidence based Education and Arts Therapies A JBI Affiliated Group Faculty of Education Palacký University Olomouc Olomouc Czech Republic

Cochrane Czech Republic The Czech Republic A JBI Centre of Excellence Czech GRADE Network Institute of Health Information and Statistics of the Czech Republic Prague Czech Republic

Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Kamuzu University of Health Sciences Blantyre Malawi

Queen Elizabeth Central Hospital Blantyre Malawi

School of Healthcare Science Cardiff University Cardiff Wales UK

Wales Centre for Evidence Based Care A JBI Centre of Excellence School of Healthcare Science Cardiff University Cardiff Wales UK

See more in PubMed

Bradfield OM. Ward rounds: the next focus for quality improvement? Aust Health Rev 2010; 34 (2):193–196.

Parissopoulos S, Timmins F, Daly L. Re-exploring the ritual of the ward round. Nursing Crit Care 2013; 8 (5):219–221.

Royal College of Physicians and Royal College of Nursing Modern Ward Rounds. Good practice for multidisciplinary inpatient review. RCP; 2021.

NICE guideline 94 emergency and acute medical care in over 16's: service delivery and organisation. Chapter 28: structured ward rounds. National Guideline Centre; 2018.

Artenstein AW, Higgins TL, Seiler A, Meyer D, Knee AB, Boynton G, et al. Promoting high value inpatient care via a coaching model of structured, interdisciplinary team rounds. Br J Hosp Med 2015; 76 (1):41–45.

Pucher PH, Aggarwal R, Qurashi M, Singh P, Darzi A. Randomized clinical trial of the impact of 27 surgical ward-care checklists on postoperative care in a simulated environment. Br J Surg 2014; 101 (13):1666–1673.

Kim MM, Barnato AE, Angus DC, Fleisher LF, Kahn JM. The effect of multidisciplinary care teams on intensive care unit mortality. Arch Intern Med 2010; 170:369–376.

Epstein NE. Multidisciplinary in-hospital teams improve patient outcomes: a review. Surg Neurol Int 2014; 5: (Suppl 7): S295–303.

Will KK, Johnson ML, Lamb G. Team-based care and patient satisfaction in the hospital setting: a systematic review. J Patient Cent Res Rev 2019; 6:158–171.

O’Leary Ritter CD, Wheeler H, Szekendi MK, Brinton TS, Williams MV. Teamwork on Inpatient Medical units: Assessing attitudes and barriers. Qual Saf Health Care 2010; 1:9117–9121.

Basheer H, Allwood B, Lindsell CM, Freeth D, Vaux E. Never too busy to learn: how the modern team can learn together in the busy workplace. Royal College of Physicians, Health Education England; 2018.

Francis R. The Mid Staffordshire NHS Foundation Trust Inquiry. The Stationery Office; 2013. Available from: https://assets.publishing.service.gov.uk/media/5a7ba0faed915d13110607c8/0947.pdf

Bradd P, Travaglia J, Hayen A. Practice development and allied health: a review of the literature. Int Prac Dev J. 2017;7(2).

Larsson E, Mawkin M, Taylor-Robinson SD, Harrington P, Gondwe H, Watson C, et al. Implementing innovative approaches to healthcare in a lower-middle income country: perspectives from Malawi. Int J Gen Med 2020; 13:1723–1730.

Porritt K, McArthur A, Lockwood C, Munn Z. JBI's approach to evidence implementation: a 7-phase process model to support and guide getting evidence into practice. JBI Evid Implement 2023; 21 (1):3–13.

Aginga C. JBI evidence summary. Ward rounds: multidisciplinary team involvement. The JBI EBP Database. 2022; JBI-ES-3356-4.

Khalil H. The triple C (consultation, collaboration and consolidation) model: a way forward to sustainability of evidence into practice. Int J Evid Based Healthc 2017; 15 (2):40–42.

Liu W, Manias E, Gerdtz M. Medication communication during ward rounds on medical wards: power relations ad spatial practices. Health 2013; 17 (2):113–134.

Jensen BE, Found PA, Williams SJ, Walley P. Improving the efficiency and effectiveness of ward rounds. Int J Qual Serv 2016; 8 (3):279–297.