Collaborative relationships between nurses and physicians may help reduce the rates of healthcare-associated infections in critical care, according to research published in Critical Care Nurse.
Study investigators found lower rates of central line-associated bloodstream infections (CLABSIs) and ventilator-associated pneumonia (VAP) in critical care units in which nurses reported a more favorable perception of nurse-physician collaboration.
“Our findings suggest that raising the quality of collaboration and communication among nurses and physicians has the potential to improve patient safety,” said study author Christine Boev, RN, PhD, CCRN, of Wegmans School of Nursing at St John Fisher College in Rochester, New York.
Dr Boev and her colleagues analyzed 5 years of data from 671 surveys of nurses in 4 specialized intensive care units (ICUs) at a 750-bed New York hospital.
The investigators also collected patient outcome data from those units for the same period, focusing on patients with CLABSIs or VAP. And the team analyzed unit-level variables such as nurses’ skill mix, nursing hours per patient day, and voluntary turnover.
Results revealed a significant association between nurse-physician collaboration and both CLABSIs and VAP. For every 0.5 unit increase in collaboration, the rate of CLABSIs decreased by 2.98 (P=0.005), and the rate of VAP decreased by 1.13 (P=0.005).
In addition, ICUs with a higher proportion of certified nurses had significantly lower incidences of both CLABSIs and VAP—0.43 (P=0.02) and 0.17 (P=0.01), respectively. And ICUs with higher numbers of nursing hours per patient day had significantly lower rates of CLABSIs—0.42 (P=0.05).
However, there was no significant difference in VAP rates according to nursing hours. And there was no significant difference in the rate of either type of infection according to nurses’ skill mix or voluntary turnover.
Dr Boev said these results suggest that efforts to prevent healthcare-associated infections should include interventions to improve nurse-physician collaboration. Such interventions might include multidisciplinary daily patient rounds and interprofessional educational programs, such as shared simulation training.
