Semester

Spring

Date of Graduation

2009

Document Type

Dissertation

Degree Type

PhD

College

School of Nursing

Department

Adult Health

Committee Chair

June H Larrabee

Abstract

Purpose. The purposes of this study were to investigate the effects of an educational intervention on knowledge, nurse-perceived nurse-physician collaboration, and compliance with quality indicators and to assess the relationship between collaboration and compliance. This study also investigated the difference in collaboration and knowledge between and within nurses from intensive care (ICU) and intermediate care (IMCU) settings.;Research questions. Six research questions guided this study. The questions compared knowledge, collaboration scores, and compliance with quality indicators between and within intermediate and intensive care unit nurses before and after an educational intervention. Questions also addressed the relationship between collaboration scores and compliance with discharge quality indicators.;Background. Nurses have knowledge of individual patients' acceptance of and reaction to health concerns. Nurses are also the central point of coordination for the interdisciplinary care team. Collaboration between nurses and physicians provides a process for discipline-specific information to be shared and team members to work together for better patient outcomes. Episodes of less than optimal collaboration between healthcare professionals lead to miscommunication and medical errors.;Method. A pretest-posttest design was used with a convenience sample of 88 registered nurses from critical care settings. Knowledge was measured by a criterion-based, investigator-developed test. Collaboration was measured using the Collaboration and Satisfaction about Care Decisions instrument. Compliance with quality indicators was determined by comparing the number of met versus expected indicators. Major limitations were a non-representative convenience sample, use of self-report instruments, assumption of complete and accurate documentation, and low power for some analyses.;Conclusions. The educational intervention was effective in improving knowledge about collaboration as well as expected quality outcomes for cardiac patients among critical care nurses. The increased knowledge resulted in improved perceptions of collaboration by IMCU nurses but not ICU nurses. This increased knowledge did not result in improved compliance with discharge quality indicators in either group of nurses. There was no relationship identified between collaboration and compliance rates.;Significance. Improvements in perceived collaboration between healthcare providers may lead to fewer episodes of miscommunication and medical errors. Participation in an educational intervention can improve perceptions of collaboration. This information may be beneficial to nurse educators as they individualize education for critical care nurses.

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