Paper: Effects of an Educational Intervention on Nurse-Physician Collaboration and Compliance Rates with Quality Indicators (40th Biennial Convention (October 31st- November 4th, 2009))

Sunday, November 1, 2009

Sara L. Clutter, PhD, RN
West Virginia University - School of Nursing, Waynesburg University, Waynesburg, PA

Learning Objective 1: identify the effect of an educational intervention on nurse-perceived nurse-physician collaboration and compliance with discharge quality indicators for cardiac patients

Learning Objective 2: identify the relationship between nurse-perceived nurse-physician collaboration and compliance with discharge quality indicators for cardiac patients

Purpose: to investigate the influence of an educational intervention on knowledge of critical care nurses about collaboration and compliance, perceptions of collaboration, and compliance with discharge quality indicator.

Method: pretest-posttest design with a convenience sample of 88 RNs from four critical care settings. Knowledge was measured by a criterion-based, investigator-developed test. Collaboration was measured using the Collaboration and Satisfaction about Care Decisions instrument. Compliance with quality indicators was determined by comparing the number of met versus expected indicators for cardiac patients.

Findings:

1. a difference between knowledge scores before and after the intervention (t = -16.207, p = .000).

2. no difference between collaboration scores (t = -.863, p = .392) or compliance rates of discharge quality indicators (t = .316, p = .754) before and after the intervention.

3. no relationship between collaboration and compliance (baseline: r = .134, p = .294; post-intervention: r = -.239, p = .114).

4. a difference in collaboration scores between nurses from intermediate care units (IMCU) and nurses from intensive care units (ICU) before (t = 3.209, p = .002) but not after the intervention (t = 1.064, p = .293).

5. no difference in knowledge scores between nurses from IMCUs and nurses from ICUs (Wilks’ Lambda = .999, F [1, 51] = .049, p = .826).

Conclusions: educational intervention improved knowledge about both collaboration and discharge quality indicators; however, this did not result in improved compliance with quality indicators. The increased knowledge resulted in improved perceptions of collaboration by IMCU but not ICU nurses. There was no relationship between perceptions of collaboration and compliance.

Significance: Improvements in perceived collaboration between healthcare providers may lead to fewer medical errors. Participation in an educational intervention can improve perceptions of collaboration. Nurse educators may use this information to individualize education for critical care nurses.

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