{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:01:22Z","timestamp":1790060482466,"version":"4.0.1"},"reference-count":17,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing in Critical Care"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In paediatric cardiac intensive care units (PCICUs), shift\u2010based safety checks are critical to ensuring equipment readiness during time\u2010sensitive emergencies. Reliance on paper\u2010based checklists resulted in variable compliance and limited accountability. A critical incident involving a non\u2010functional defibrillator during a paediatric cardiac arrest was identified as a system\u2010level failure rather than individual staff error, exposing the risk of unpreparedness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To improve and sustain compliance with shift safety checks through a QR code\u2010based digital checklist system with automated reminders and escalation, enhancing patient safety and staff readiness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Following root cause analysis and guided by a Just Culture approach, this quality improvement project, conducted in a tertiary PCICU in the United Arab Emirates, used Kotter's eight\u2010step change model and Plan\u2013Do\u2013Check\u2013Act (PDCA) cycles. A multidisciplinary team developed a mobile\u2010accessible digital checklist. QR codes were placed on critical equipment and clinical areas. Staff scanned the QR code at the item location and completed checks in real time. Microsoft Power Automate sent reminders to the team leader after 2\u2009h, with escalation to the unit manager after 3\u2009h if checks remained incomplete. The intervention was piloted over 1\u2009month and expanded unit wide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compliance with shift safety checks improved from a baseline of 82% to 90% at 3\u2009months. After resolution of technical issues and reinforcement of staff education, compliance reached and was sustained at 100% by 6\u2009months. Staff satisfaction increased from 68% at baseline to 91% at 3\u2009months and 96.3% at 6\u2009months. Documentation became fully auditable, equipment readiness at the start of each shift markedly improved, and no further critical equipment failures were reported during emergency events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Sustained improvement was achieved by combining accessible digital technology with structured change management, iterative PDCA cycles and a Just Culture approach, supporting durable transformation of shift safety checks in a high\u2010acuity PCICU.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Relevance to Clinical Practice<\/jats:title>\n                    <jats:p>QR code\u2010based digital checklists with automated reminders and escalation offer a low\u2010cost, scalable approach for critical care units to strengthen equipment readiness, enable real\u2010time documentation at the point of checking, improve auditability and reduce reliance on paper and time away from patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nicc.70622","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T08:48:47Z","timestamp":1786006127000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["From Paper to Proactive Safety: Digitalising Shift Checklists in a Paediatric Cardiac\n                    <scp>ICU<\/scp>"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-3593-2194","authenticated-orcid":false,"given":"Mohamed","family":"Gamal","sequence":"first","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9565-3563","authenticated-orcid":false,"given":"Reda","family":"Elsahy","sequence":"additional","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Farina","sequence":"additional","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munira","family":"Almaazmi","sequence":"additional","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5170-9904","authenticated-orcid":false,"given":"Hisham","family":"Abdulla","sequence":"additional","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuser","family":"Hamad","sequence":"additional","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7915-9594","authenticated-orcid":false,"given":"Shabaan","family":"Osman","sequence":"additional","affiliation":[{"name":"Al Jalila Children's Hospital  Dubai UAE"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04758-2"},{"key":"e_1_2_12_3_1","volume-title":"CHI 2019: Proceedings of the 2019 CHI Conference on Human Factors in Computing Systems","author":"Kulp L.","year":"2019"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bja.2020.09.044"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0885066614558015"},{"issue":"3","key":"e_1_2_12_6_1","first-page":"400","article-title":"Just Culture: A Foundation for Balanced Accountability and Patient Safety","volume":"13","author":"Boysen P. 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