Collaboration between nurses and physicians decreases rates of HAIs in critical care

Collaborative relationships between nurses and physicians decrease rates of healthcare-associated infections (HAIs) in critical care, according to an article in the April issue of Critical Care Nurse (CCN).

The article, "Nurse-Physician Collaboration and Hospital-Acquired Infections in Critical Care," examines the association between nurses' perception of their working relationships with physicians and the rates of two of the most common HAIs.

The research team found that lower rates of ventilator-associated pneumonia (VAP) and central line-associated bloodstream infection (CLABSI) occurred 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. "Efforts to prevent healthcare-associated infections must include interventions to improve nurse-physician collaboration."

Boev is an assistant professor, Wegmans School of Nursing, St. John Fisher College, Rochester, New York.

She points to multidisciplinary daily patient rounds and interprofessional educational programs, such as shared simulation training, as examples of interventions that improve nurse-physician collaboration.

For the study, the researchers conducted a secondary analysis of five years of nurse perception data from 671 surveys of nurses in four specialized intensive care units (ICUs) at a 750-bed New York hospital. They also collected patient outcome data from those units for the same period, focusing on patients with CLABSI or VAP.

Also included in the analysis were unit-level variables such as nurses' skill mix, nursing hours per patient day and voluntary turnover. Findings related to those variables include:
•ICUs with a higher proportion of certified nurses were associated with lower incidences of both CLABSI and VAP.
•ICUs with higher numbers of nursing hours per patient day were associated with decreased rates of CLABSI.
•The research team did not find any correlation between nurses' skill mix and voluntary turnover on HAI rates.

As the American Association of Critical-Care Nurses' bimonthly clinical practice journal for high acuity, progressive and critical care nurses, CCN is a trusted source for information related to the bedside care of critically and acutely ill patients.

The study provides the latest data to support the link between work environments and patient outcomes, an underlying tenet of AACN's healthy work environment initiative and its "AACN Standards for Establishing and Sustaining Healthy Work Environments" report.