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, according to findings presented recently at the annual meeting of the American Thoracic Society.
Deena Kelly Costa, PhD, RN, 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 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% CI, 0.25 to 1.38). There was a significant interaction between the nurse work environment and ICU 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.
1. Costa DK, Yang J, Manojlovich M, et al. Abstract 4665. How the Nurse Work Environment and ICU Physician Staffing Influence Risk of VentilatorAssociated Pneumonia. Presented at: ATS 2016. May 13-18, 2016. San Francisco.