Baggs J G, Schmitt M H, Mushlin A I, Mitchell P H, Eldredge D H, Oakes D, Hutson A D
School of Nursing, University of Rochester, NY 14642-8404, USA.
Crit Care Med. 1999 Sep;27(9):1991-8. doi: 10.1097/00003246-199909000-00045.
To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome.
Prospective, descriptive, correlational study using self-report instruments.
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.
Ninety-seven attending physicians, 63 resident physicians, and 162 staff nurses.
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.
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.
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.
The study offered some support for the importance of physician-nurse collaboration in ICU care delivery, a variable susceptible to intervention and further study.
探讨重症监护病房（ICU）医生与护士之间的协作与患者预后的关联。
使用自我报告工具进行的前瞻性、描述性、相关性研究。
纽约州北部的一家社区教学医院的内科重症监护病房、一家大学教学医院的外科重症监护病房以及一家社区非教学医院的综合重症监护病房。
97名主治医师、63名住院医师和162名护士。
当患者准备从重症监护病房转至护理强度较低的区域时，使用问卷评估护理人员在做出转院决定时的协作报告。在控制疾病严重程度后，评估跨专业协作与患者预后之间的关联。对科室层面的组织协作和患者预后进行排名。
医疗服务提供者报告的协作水平、患者的疾病严重程度和个体风险、患者死亡或再次入住重症监护病房的预后、科室层面的协作以及科室患者出现不良预后的风险。
内科重症监护病房护士的协作报告与患者预后呈正相关。未发现其他协作报告与患者预后之间的关联。三个科室在科室层面的组织协作与患者预后之间存在完全的等级相关。
该研究为医生与护士协作在重症监护病房护理中的重要性提供了一些支持，这是一个易于干预和进一步研究的变量。
