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Keywords:

  • clinical decision making;
  • clinical judgement;
  • clinical reasoning;
  • collaboration;
  • critical care;
  • intensive care units;
  • multidisciplinary practice;
  • nurse–physician interaction;
  • patient outcomes;
  • problem-solving

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

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, adjusting for risk. The convenience sample consisted of 175 patient transfer decisions. Charts and computerized databases were used to collect patient information, and a questionnaire developed by the investigator was used to obtain demographic data from the 42 medical intensive care nurses. An adapted version of the Decision About Transfer 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 was utilized to adjust for patient risk. Information Processing Theory guided the study.

Hierarchical logistic regression analyses 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 0·28 revealed a statistically significant (= 0·000), positive relationship between the nurses’ perceptions of collaboration and their satisfaction with the decision making process about decisions to transfer.