Team-Based Nursing in the Intensive Care Unit: A Review of Evidence on Improving Outcomes in Critically Ill Patients

Background: Teamwork among healthcare professionals is a key determinant of patient safety and is closely linked to missed nursing care. In Intensive Care Units (ICUs), where a large proportion of critically ill patients receive mechanically ventilated (MV) support, effective collaboration among physicians, nurses, and respiratory therapists is essential. Inadequate MV management can result in complications such as pneumonia and prolonged ventilator dependence. Missed nursing care—defined as any required care that is omitted in whole or in part, or delayed—includes activities such as ambulation, mouth care, bathing, mobilization, and explaining procedures. Strengthening ICU nurses’ teamwork attitudes may reduce missed care and nurses’ intent to leave. Methods: This study examined the relationship between ICU nurses’ teamwork attitudes, the frequency of missed nursing care in MV patients, and nurses’ intent to leave. Standardized questionnaires were used to measure teamwork attitudes, types and frequency of missed care, and intent to leave. Data were analyzed using descriptive and inferential statistics. Results: Higher teamwork attitude scores were associated with lower frequencies of missed nursing care, particularly in basic care and patient education activities. Nurses with more positive teamwork attitudes also reported a lower intent to leave their current position. Teamwork attitudes emerged as a significant predictor of both missed nursing care and intent to leave. Conclusion: Enhancing teamwork attitudes among ICU nurses may reduce missed nursing care and improve the safety and quality of care for mechanically ventilated patients, while also decreasing nurses’ intent to leave. Interventions to promote effective teamwork in ICUs should be considered a strategic priority.

کلیدواژه ها:

Intensive Care Unit (ICU) ، teamwork attitudes ، missed nursing care ، mechanically ventilated patients ، intent to leave ، patient safety