Nurses' perceptions of collaborative nurse-physician transfer decision-making as a predictor of patient outcomes in a medical intensive care unit

Abstract

<p>This prospective correlational study examined nurses' perceptions of collaborative nurse-physician transfer decision making as a predictor of patient outcomes in a medical intensive care unit (MICU), adjusting for risk. The convenience sample consisted of 175 patient transfer decisions. Patient charts, computerized patient databases, and weekly telephone conversations with a patient care coordinator were used to collect patient information, and a questionnaire developed by the investigator was used to obtain demographic data from the 42 MICU nurses. An adapted version of the Decision About Transfer (DAT) scale served to measure the nurses' perceptions of collaboration and satisfaction with respect to specific patient transfer decisions, as well as decision task complexity, and the Acute Physiology and Chronic Health Evaluation (APACHE III) was utilized to adjust for patient risk. Using an SPSS computer program, the data were analyzed via hierarchical logistic regression (LR) and correlation coefficients. Testing the main effects as well as the interaction terms of various models and examining the improvement in chi-square statistics, the hierarchical logistic regression analysis first showed that the nurses' perceptions of collaboration were not a significant predictor of patient outcomes. Furthermore, the analysis also showed that decision task complexity and the nurses' years of critical care experience did not significantly moderate the contribution of nurses' perceptions of collaboration to patient outcome prediction. Finally, a Pearson product moment correlation coefficient of.28 revealed a statistically significant (p &lt; .000), positive relationship between the nurses' perceptions of collaboration and their satisfaction with the decision making process about decisions to transfer. Implications of the research findings were discussed and recommendations for future research were made.</p>