The indirect patient care effect of a unit-based clinical nurse specialist on preventable pulmonary complications.
OBJECTIVE
To examine the indirect effect of a unit-based expert nurse on the incidence of preventable pulmonary complications, which were defined as malpositioned endotracheal tube and inadvertent extubation.


METHODS
A nonequivalent control group/separate samples pretest/posttest design was used to test differences in the incidence of preventable pulmonary complications before and after a 6-month intervention by a unit-based expert nurse in the experimental unit. Retrospective medical record audits were used to collect data on all consecutive admissions to the experimental and control units in March and April of years 1 and 2.


RESULTS
Estimated risk ratios demonstrated a significant reduction in preventable pulmonary complications in the experimental unit after the test, even though the acuity was significantly higher in posttest patients. It was concluded that indirect patient care by a unit-based clinical nurse specialist can reduce the incidence of preventable pulmonary complications.
Hanneman
S K
SK
Texas Woman's University, Houston.
Bines
A S
AS
Sajtar
W S
WS
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003953:Diagnosis-Related Groups; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D007442:Intubation, Intratracheal / Q000009:adverse effects* / Q000451:nursing* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009720:Nurse Clinicians / Q000592:standards*; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate