Nurse-physician collaboration in an intensive care unit

2001 ◽  
Vol 10 (5) ◽  
pp. 341-350 ◽  
Author(s):  
PA Miller
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Quality Improvement ◽  
National Study ◽  
Improvement Program ◽  
Critical Care Units ◽  
Improvement Programs ◽  
Nurses And Physicians ◽  
Collaborative Interaction

BACKGROUND: Collaborative interaction between nurses and physicians on critical care units is significantly related to mortality rates and length of stay in the units. For this reason, collaborative interaction should be an integral part of quality improvement programs. OBJECTIVES: To examine perspectives of nurses and physicians on collaborative interaction in an intensive care unit, to examine differences between groups in perceptions of collaborative interaction in the unit, and to compare this unit with units examined in a national study. METHODS: A modification of the ICU Nurse-Physician Questionnaire was used to collect data from 35 nurses and 45 physicians. Descriptive statistics and analysis of variance were used to determine group scores and to examine differences between groups. RESULTS: The level of collaborative interaction in the unit was high. However, nurses and physicians and all other staff groups examined except one had significant differences in perceptions of collaborative interaction. The high level of collaborative interaction was confirmed by a comparison of the results with the results from a national sample. CONCLUSIONS: Critical care units can use this example to incorporate an assessment of the level of collaborative interaction into their quality improvement program.

scholarly journals Assessing Nurses’ Knowledge of Noise in the Intensive Care Unit: An Educational Intervention Project

2021 ◽  
Author(s):  
Jennifer Fortes
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Quality Improvement ◽  
Educational Intervention ◽  
Quality Improvement Project ◽  
Minimal Risk ◽  
Improvement Project ◽  
Staff Members ◽  
Nurses Knowledge

Noise in the intensive care unit (ICU) has been studied for over thirty years, but it continues to be a significant problem and a top complaint among patients. Staff members are now reporting detrimental health effects from excessive noise. One of the significant factors of inadequate noise control in the ICU is that nurses have insufficient awareness regarding the hospital noise issue and its negative impact on health status. The level of knowledge of clinical staff on the topic of noise is not known. A quality improvement project to explore noise in the ICU could facilitate better understanding of the phenomenon and formulation of new ways to continue to reduce noise at a community hospital in Massachusetts. The purpose of this quality improvement project was to evaluate nurses’ knowledge of the potentially harmful effects of noise on patients as well as on nurses, to identify opportunities for improvement of the environment, and to conduct an educational intervention aimed at reducing noise in the intensive care unit. The methodology for this project included a pre-test, followed by an educational session, and completion of a post-test. The participants included registered nurse staff members in the Intensive Care Unit (ICU) and the Critical Care Unit (CCU). Exclusion criteria included staff members who are not registered nurses. The project posed minimal risk. No identifying or biographical data was collected, and results included analysis of aggregate data. Descriptive statistics were used to assist with analysis. Results were disseminated to the staff of the ICU and CCU, posted on a bulletin board in the critical care area, presented as a poster presentation at the Spring RIC MSN Symposium, and available as a manuscript on the RIC Digital Commons.

Quality Improvement in the Surgical Intensive Care Unit

2015 ◽  
Author(s):  
Mark R. Hemmila ◽  
Wendy L Wahl
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Propensity Score Analysis ◽  
Scoring Systems ◽  
Quality Improvement Program ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Improvement Program ◽  
Vte Prophylaxis

Programs to support clinical benchmarking of surgical outcomes have grown dramatically over the past decade. Selection of an appropriate project and preplanning with regard to strategy are often more important than management skill alone when undertaking and performing successful quality improvement in the intensive care unit (ICU) setting. This review covers an overview of a medical and surgical quality system, development of an ICU quality improvement program, scoring systems: risk assessment, evidence-based medicine and protocols, and a quality improvement framework. Figures show structure of the ICU quality improvement team, the C-index statistic reflecting the ability of a model to predict which patients will have the outcome of interest, a Shewhart statistical process control chart, venous thromboembolism (VTE) events by report number, and changes in the type of VTE prophylaxis agent administered over time.  Tables list Blue Cross Blue Shield of Michigan/Blue Care Network-sponsored, registry-based collaborative quality initiatives, critical care societies’ collaborative-based quality improvement task force priorities for performance measurement, possible ICU quality measures, predictive scoring systems, and multivariate and propensity score analysis of the Michigan Trauma Quality Improvement Program pilot data for VTE events and type of VTE prophylaxis.   This review contains 5 highly rendered figures, 5 tables, and 59 references

Answering the Call: Impact of Tele-ICU Nurses During the COVID-19 Pandemic

2020 ◽  
Vol 40 (4) ◽  
pp. 25-31 ◽  
Author(s):  
Sandy L. Arneson ◽  
Sara J. Tucker ◽  
Marie Mercier ◽  
Jaspal Singh
Keyword(s):  
Intensive Care Unit ◽  
Critical Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Holistic Approach ◽  
Critical Care Units ◽  
Work From Home ◽  
New Strategy ◽  
High Level ◽  
Intensive Care Unit Nurses

Background The coronavirus disease 2019 pandemic has exacerbated staffing challenges already facing critical care nurses in intensive care units. Many intensive care units have been understaffed and the majority of nurses working in these units have little experience. Objective To describe how the skilled tele–intensive care unit nurses in our health system quickly changed from a patient-focused strategy to a clinician-focused approach during the coronavirus disease 2019 crisis. Methods We modified workflows, deployed home workstations, and changed staffing models with the goal of providing additional clinical support to bedside colleagues while reducing exposure time and conserving personal protective equipment for those caring for this highly contagious patient population. The unit changed focus and granted more than 300 clinicians access to technology that enabled them to care for patients remotely, added nearly 200 mobile carts, and allowed more than 20 tele–intensive care unit nurses to work from home. Results Tele–intensive care unit nursing provided clinical knowledge to the nurses covering current and expanded critical care units. Using technology, virtual rounding, and increased collaboration with nurses, tele–intensive care unit nursing minimized the risk to bedside nurses while maintaining a high level of care for patients. Conclusion Tele–intensive care unit nurses provided a proactive, holistic approach to caring for critically ill patients via camera as part of their routine workflow. In addition, during the coronavirus disease 2019 pandemic, these nurses created a new strategy in virtual health care to be implemented during a crisis.

Quality Improvement Program to Reduce the Prevalence of Pressure Ulcers in an Intensive Care Unit

2008 ◽  
Vol 17 (4) ◽  
pp. 328-334 ◽  
Author(s):  
Rosalind Elliott ◽  
Sharon McKinley ◽  
Vicki Fox
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Pressure Ulcers ◽  
Anatomical Site ◽  
Clinical Expertise ◽  
Improvement Program ◽  
Improvement Project ◽  
Increased Risk ◽  
Quasi Experimental

Background Critically ill patients are at increased risk for pressure ulcers, which increase patients’ morbidity and mortality. Quality improvement projects decrease the frequency of pressure ulcers. Objectives To improve patients’ outcomes by reducing the prevalence of pressure ulcers, identifying areas for improvement in prevention of pressure ulcers, and increasing the adoption of preventive strategies in an intensive care unit. Method Quasi-experimental methods were used for this quality improvement project in which 563 surveys of patients’ skin were performed during 22 audits conducted during a 26-month period. One-on-one clinical instruction was provided to bedside nurses during the surveys, and pressure ulcer data were displayed in the clinical area. Results The frequency of pressure ulcers of all stages showed an overall downward trend, and the prevalence decreased from 50% to 8%. The appropriate allocation of pressure-relieving devices increased from 75% up to 95% to 100%. The likely origin of the ulcer (ie, whether it was hospital or community acquired) and the anatomical site of the pressure ulcers did not change during the study period. Conclusions This program was successful in reducing the prevalence of pressure ulcers among vulnerable intensive care patients and indicates that quality improvement is a highly effective formula for improving patients’ outcomes that is easily implemented by using clinical expertise and existing resources.

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