Cohesive interdisciplinary teamwork is crucial to the safe care of critically ill children. Core competencies put forth by the Institute of Medicine support the delivery of patient-centered care by interdisciplinary teams. Moreover, the American Association of Critical-Care Nurses aligns standards for healthy work environments with the Institute of Medicine competencies, thereby committing to (1) skilled communication, (2) true collaboration, and (3) effective decision making specific to safe patient care.

The traditional bedside rounding process in the pediatric intensive care unit (PICU) was exclusive to the presentation of patients by resident, fellow, and attending physicians. Although input from the staff nurses was always respected and valued, their informal role in the rounding process never grew to that of a leader.

Physicians identified gaps with the implementation of patient care orders and communication. Meanwhile, nurses were challenged by a different physical environment that included single patient rooms in a new...

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