Nurse-Physician Collaboration and Hospital-Acquired Infections in Critical Care

BACKGROUND Nurse-physician collaboration may be related to outcomes in health care-associated infections. OBJECTIVE To examine the relationship between nurse-physician collaboration and health care-associated infections in critically ill adults. METHODS A secondary analysis was done of 5 years of nurses' perception data from 671 surveys from 4 intensive care units. Ventilator-associated pneumonia and central catheter-associated bloodstream infections were examined. Multilevel modeling was used to examine relationships between nurse-physician collaboration and the 2 infections. RESULTS Nurse-physician collaboration was significantly related to both infections. For every 0.5 unit increase in collaboration, the rate of the bloodstream infections decreased by 2.98 (P=.005) and that of pneumonia by 1.13 (P=.005). Intensive care units with a higher proportion of certified nurses were associated with a 0.43 lower incidence of bloodstream infections (P=.02) and a 0.17 lower rate of the pneumonia (P=.01). With nursing hours per patient day as a covariate, units with more nursing hours per patient day were associated with a 0.42 decrease in the rate of bloodstream infections (P=.05). CONCLUSION Nurse-physician collaboration was significantly related to health care-associated infections.