Collaboration: A tool addressing ethical issues for elderly patients near the end of life in intensive care units
The purpose of this article is to propose that collaboration is a valuable way to address ethical issues associated with the treatment of elderly patients near the end of life in intensive care units (ICUs). Collaboration among health care providers and with patients and their families has been called “an ethical responsibility of the highest priority” (Levine, 1989, p. 5).
Association between nurse-physician collaboration and patient outcomes in three intensive care units
OBJECTIVE: To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome.
DESIGN: Prospective, descriptive, correlational study using self-report instruments.
SETTINGS: 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.
SUBJECTS: Ninety-seven attending physicians, 63 resident physicians, and 162 staff nurses.
Nurses' and resident physicians' perceptions of the process of collaboration in an MICU
Ten intensive care unit nurses and 10 medical resident physicians were interviewed to compare their perceptions of the process of nurse-physician collaboration. The grounded theory method for concept development recommended by Strauss and Corbin (1990) was used. The core of the process of collaboration for both groups was working together.
Nurse-physician collaboration and satisfaction with the decision-making process in three critical care units
OBJECTIVE: To assess and compare levels of nurse-physician collaboration and satisfaction with the decision-making process as reported by critical care nurses, resident physicians (residents), and attending physicians (attendings) in making decisions to transfer individual patients out of the critical care unit, and to assess if satisfaction predicts nurse retention.
DESIGN: Longitudinal descriptive correlational study using self-reporting instruments.
Development of an instrument to measure collaboration and satisfaction about care decisions
The psychometric assessment of a new instrument for measurement of the construct of nurse-physician collaboration in making specific patient care decisions. Collaboration and Satisfaction About Care Decisions (CSACD), is reported. Content validity for the tool was supported by literature review, nurse and physician experts, and potential subjects. In a pilot study 58 neonatal intensive care nurses' and resident physicians' responses showed variance; alpha reliability of the collaboration questions was 0.95.
Two instruments to measure interdisciplinary bioethical decision making
OBJECTIVE: To develop and test two instruments measuring decision making about level of aggressiveness of intensive care unit (ICU) patient care. Decisions about Aggressiveness of Patient Care (DAC) measures care providers' general perceptions about decision making. Decisions about Aggressiveness of Patient Care for Specific Patients (DAC[SP]) measures perceptions in specific situations.
DESIGN: Two-phase psychometric instrument evaluation.
SETTING: Phase I, nationally mailed questionnaire. Phase II, northeastern medical center medical ICU.
The association between interdisciplinary collaboration and patient outcomes in a medical intensive care
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.
ICU nurse-physician collaboration & nursing satisfaction
ICU nurses who are satisfied with their work are more likely to be retained, leading to institutional cost savings. In this study, higher levels of nurse-physician collaboration in making decisions about patient care were found to be very important to nurses' satisfaction.
Assessment and Evaluation in IPE: Collaboration and Satisfaction About Care Decisions (CSACD)
Join Judith Baggs as she presents information about the development, testing, and use of the Collaboration and Satisfaction about Care Decisions (CSACD) instrument. Since its initial development, this tool has been used for assessment by patients, patient families, and care providers in acute care and primary care settings. Join us for a discussion of this innovative tool, how it relates to the IPEC competencies, and how it might be adapted for use in interprofessional education and practice.
Learning Objectives for webinar participants are:
