Theoretical Framework
The Synergy Model from the American Association
of Critical-Care Nurses provided a theoretical framework
for the clinical nurse specialists’ (CNSs’) interest in
and design of this study.29 This model encourages a
holistic view of patients, each with varying capacities
for health and vulnerability to illness. The model also
identifies nursing’s unique contribution to patient care
and outcomes. The patient characteristics of the Synergy
Model that apply particularly well in our study are
the complexity and vulnerability of ICU patients as
well as their limited available resources to prevent
hospital-acquired infections. The ICU itself is a complex
environment that can place patients at risk of having
hospital-acquired complications. The CNSs bring the
nursing competencies of clinical inquiry, collaboration,
and facilitation of learning to the clinical research project.
If the intervention reduced MRSA acquisition, our
study worked toward patient outcomes goals of absence
of complications, decreased infection acquisition, and
effective cost-resource utilization.