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Learning Objective 1: Explore the relationship between nurse-physician collaboration and Healthcare Associated Infections in adult critical care.
Learning Objective 2: Identify unit-level variables that contribute to Healthcare Associated Infections in adult critical care.
Methods: This study was a secondary analysis of existing data. Nurse/physician collaboration was measured annually for five years (2005-2009) using the Collaboration and Satisfaction about Care Decisions (CSACD) developed by Baggs (1994). A total of 671 surveys were collected from four intensive care units over the five year study period and the data were aggregated at the unit level. HAIs measured were ventilator-associated pneumonia (VAP) and central line-associated blood stream infection (CLABSI). Nursing demographics, certification, education, and experience were included in the models. Patient age and severity of illness served as control variables. Multilevel modeling was used to examine the relationships between nurse/physician collaboration and HAIs.
Results: Nurse-physician collaboration was significantly related to both VAP and CLABSI. Units with higher nurse-physician collaboration were assoicated with a 2.25 decrease in VAP (p<.004) and a 5.95 decrease in CLABSI (p<.005). ICU units with a higher proportion of CCRN certified nurses were associated with a 0.44 lower incidence of CLABSI (p<.01) as well as a .17l ower incidence of VAP (p<.01). RN hours per patient day served as a covariate and we found that units with higher RN hours per patient days were associated with a 0.42 decrease in CLABSI (p<.05).
Conclusion: Nurse-physician collaboration is an important aspect of the nursing work environment and was significnatly related to HAIs.
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