Baggs J G, Ryan S A, Phelps C E, Richeson J F, Johnson J E
School of Nursing, Department of Preventive and Community Medicine, University of Rochester, NY 14642.
Heart Lung. 1992 Jan;21(1):18-24.
We prospectively studied the relationship between interdisciplinary collaboration and patient outcomes in the medical intensive care unit (MICU) using nurses' and residents' reports of amount of collaboration involved in making decisions about transferring patients from the MICU to a unit with a less intense level of care. Either readmission to the MICU or death was considered a negative patient outcome. Nurses' reports of collaboration were significantly (p = 0.02) and positively associated with patient outcome, controlling for severity of illness. Patient predicted risk of negative outcome decreased from 16%, when the nurse reported no collaboration in decision making, to 5% when the process was fully collaborative. There was an interaction of collaboration with availability of alternative choices in the transfer decision-making situation. When alternatives were available, collaboration was more strongly associated with patient outcome. There was no significant relationship between residents' reports of collaboration and patient outcomes. The correlation between amount of collaboration reported by nurses and residents about the same decisions was quite low (r = 0.10).
我们前瞻性地研究了在医疗重症监护病房（MICU）中跨学科协作与患者预后之间的关系，采用护士和住院医师关于在做出将患者从MICU转至护理强度较低科室的决策过程中所涉及协作量的报告。再次入住MICU或死亡被视为不良患者预后。在控制疾病严重程度的情况下，护士的协作报告与患者预后显著（p = 0.02）且呈正相关。当护士报告决策过程无协作时，患者不良预后的预测风险为16%，而当过程完全协作时，该风险降至5%。在转科决策情境中，协作与可替代选择的可用性之间存在交互作用。当有替代选择时，协作与患者预后的关联更强。住院医师的协作报告与患者预后之间无显著关系。护士和住院医师关于相同决策所报告的协作量之间的相关性相当低（r = 0.10）。
