Better nurse work environment may minimize ventilator-associated pneumonia risk
TUESDAY, May 17, 2016 (HealthDay News) — Nurse work environment is a significant predictor of ventilator-associated pneumonia (VAP) when controlling for intensive care unit (ICU) physician staffing, with the effect of the nurse work environment varying according to physician staffing. These findings were presented at the annual meeting of the American Thoracic Society, held from May 13 to 18 in San Francisco.
Deena Kelly Costa, Ph.D., R.N., from the University of Michigan in Ann Arbor, and colleagues conducted a secondary unit-level analysis of nurse survey data from 25 ICUs to model the independent and joint effects of the nurse work environment and ICU physician staffing on VAP. Four hundred sixty-two nurses nested in 25 ICUs participated in the parent study.
The researchers found that a one-unit increase in the nurse work environment correlated with a significant increase in VAP risk (adjusted incident rate ratio [aIRR], 5.79; 95 percent confidence interval [CI], 1.33 to 25.17). There was no correlation for a closed ICU physician staffing model with VAP risk (aIRR, 0.59; 95 percent CI, 0.25 to 1.38). There was a significant interaction between the nurse work environment and ICU physician staffing on VAP (P < 0.001); a one-unit increase in the nurse work environment correlated with significantly increased risk of VAPs in closed ICUs and with a significantly lower risk of VAPs in open ICUs.
“These findings highlight a novel view that minimizing VAP may depend on fostering organizational collaboration between ICU nursing and medicine,” the authors write.
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