Healthy work environments, nurse-physician communication, and patients' outcomes.
Healthy work environments, nurse-physician communication, and patients' outcomes.
复制标题
健康的工作环境、护士与医生的沟通以及患者的治疗结果。
DOI：
10.4037/ajcc2007.16.6.536
复制
发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Barry DeCicco
中科院分区：
文献类型：
--
作者：
Milisa Manojlovich;Barry DeCicco
背景
不良事件和严重错误在重症监护中很常见。虽然工作环境中的因素是患者不良结局的重要预测因素，但护士和医生之间的沟通可能是与重症监护环境中医院死亡率过高相关的最重要因素。
目标
探讨护士对其执业环境的认知、护医沟通与所选病人治疗结果之间的关系。
方法
一个非实验性的，描述性的设计，并在密歇根州东南部的25个重症监护病房工作的所有护士（N=866）进行了调查。采用护理工作指数中的工作有效性条件量表II和实践环境量表测量工作环境特征;采用ICU护医沟通问卷测量护医沟通。护士自我评估呼吸机相关性肺炎、导管相关性脓毒症和其护理下患者用药错误的频率。
结果
共有462名护士（53%）回答。根据多层次模型，这两个实践环境规模占47%的护士-医生沟通得分的方差（P= 0.001）。护士-医生沟通仅预测护士评估的用药错误（R2=0.11）。两种环境量表均不能预测任何患者结局。
结论
健康的工作环境对护医沟通很重要。在重症监护病房中，工作环境的特征变化不足以显著预测结果，这表明即使在各种类型的重症监护病房中，工作环境的特征也可能相似而不是不同。
BACKGROUND
Adverse events and serious errors are common in critical care. Although factors in the work environment are important predictors of adverse outcomes for patients, communication between nurses and physicians may be the most significant factor associated with excess hospital mortality in critical care settings.
OBJECTIVES
To examine the relationships between nurses' perceptions of their practice environment, nurse-physician communication, and selected patients' outcomes.
METHODS
A nonexperimental, descriptive design was used, and all nurses (N=866) working in 25 intensive care units in southeastern Michigan were surveyed. The Conditions for Work Effectiveness Questionnaire-II and the Practice Environment Scale of the Nursing Work Index were used to measure characteristics of the work environment; the ICU Nurse-Physician Questionnaire was used to measure nurse-physician communication. Nurses self-rated the frequency of ventilator-associated pneumonia, catheter-related sepsis, and medication errors in patients under their care.
RESULTS
A total of 462 nurses (53%) responded. According to multilevel modeling, both practice environment scales accounted for 47% of the variance in nurse-physician communication scores (P=.001). Nurse-physician communication was predictive of nurse-assessed medication errors only (R2=0.11). Neither environment scale was predictive of any of the patient outcomes.
CONCLUSIONS
Healthy work environments are important for nurse-physician communication. In intensive care units, characteristics of the work environment did not vary enough to be significantly predictive of outcomes, suggesting that even in various types of critical care units, characteristics of the work environment may be more similar than different.
影响因子：
2
作者：
Lake, ET
通讯作者：
Lake, ET
重症监护结果：将结构、流程以及组织和临床结果联系起来。
DOI：
--
发表时间：
1996
期刊：
American journal of critical care : an official publication, American Association of Critical-Care Nurses.
影响因子：
--
作者：
Mitchell,PH;Shannon,SE;Cain,KC;Hegyvary,ST
通讯作者：
Hegyvary,ST