Association between nurse-physician collaboration and patient outcomes in three intensive care units.

Abstract:

OBJECTIVE:To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome. DESIGN:Prospective, descriptive, correlational study using self-report instruments. SETTINGS:A community teaching hospital medical ICU, a university teaching hospital surgical ICU, and a community non-teaching hospital mixed ICU, all in upstate New York. SUBJECTS:Ninety-seven attending physicians, 63 resident physicians, and 162 staff nurses. PROCEDURE:When patients were ready for transfer from the ICU to an area of less intensive care, questionnaires were used to assess care providers' reports of collaboration in making the transfer decision. After controlling for severity of illness, the association between interprofessional collaboration and patient outcome was assessed. Unit-level organizational collaboration and patient outcomes were ranked. MEASURES:Healthcare providers' reported levels of collaboration, patient severity of illness and individual risk, patient outcomes of death or readmission to the ICU, unit-level collaboration, and unit patient risk of negative outcome. MAIN RESULTS:Medical ICU nurses' reports of collaboration were associated positively with patient outcomes. No other associations between individual reports of collaboration and patient outcome were found. There was a perfect rank order correlation between unit-level organizational collaboration and patient outcomes across the three units. CONCLUSIONS:The study offered some support for the importance of physician-nurse collaboration in ICU care delivery, a variable susceptible to intervention and further study.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Baggs JG,Schmitt MH,Mushlin AI,Mitchell PH,Eldredge DH,Oakes D,Hutson AD

doi

10.1097/00003246-199909000-00045

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

1991-8

issue

9

eissn

0090-3493

issn

1530-0293

journal_volume

27

pub_type

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