Nurse Practitioner and Physician Assistant-led Cardiovascular Surgery Postoperative Intensive Care Unit Staffing Model.

IF 3 3区医学 Q2 CRITICAL CARE MEDICINE

Journal of Intensive Care Medicine Pub Date : 2025-02-01 Epub Date: 2024-08-02 DOI:10.1177/08850666241268458

Ralph T Perry, John W Weimer, Carrie Pratt, Marci D Newcome, Gabor Bagameri, J Kyle Bohman

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引用次数: 0

Abstract

Objectives: To determine whether a nurse practitioner and physician assistant (NP/PA)-led rapid staffing. Model in the cardiac surgical intensive care unit (ICU) can optimize resource utilization without compromising safety or increasing hospital length of stay (LoS).

Design: Retrospective observational cohort study comparing before-and-after implementation of an NP/PA-led rapid recovery pathway.

Setting: A large tertiary referral academic cardiac surgery ICU.

Participants: There were 116 patients in the prerapid recovery cohort and 153 in the postimplementation rapid recovery phase.

Interventions: Low-risk cardiac surgery patients were selected for postoperative care by an NP/PA-led ICU staffing model.

Measurements and main results: Mean hospital LoS in the prerapid recovery cohort was 5.7 days compared to 5.2 days in the rapid recovery pathway cohort (P = .02). Thirty-day hospital readmission in the prerapid recovery pathway cohort was 7.8% compared with 2.0% in the rapid recovery cohort (P = .04). The ICU readmission rate for prerapid recovery cohort was 4.3%, while the rapid recovery percentage was 2.0% (P = .30).

Conclusions: Overall, implementation of an NP/PA-led postcardiac surgical ICU team (rapid recovery pathway) was associated with similar ICU LoS, hospital LoS, ICU readmission rates, 30-day readmission rates, and no significant signal of increased adverse events or safety concerns.

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由执业护士和医生助理领导的心血管外科术后重症监护室人员配备模式。

目的确定由执业护士和助理医师（NP/PA）领导的心脏外科重症监护室快速人员配置模式能否在不影响安全性或延长住院时间（LoS）的情况下优化资源利用率。心脏外科重症监护室（ICU）的快速人员配置模式能否在不影响安全性或增加住院时间（LoS）的情况下优化资源利用：设计：回顾性观察队列研究，比较 NP/PA 领导的快速恢复路径实施前后的情况：环境：大型三级转诊心脏外科重症监护病房：快速恢复前有 116 名患者，实施快速恢复后有 153 名患者：干预措施：通过NP/PA主导的ICU人员配置模式选择低风险心脏手术患者进行术后护理：快速恢复前队列的平均住院时间为 5.7 天，而快速恢复路径队列的平均住院时间为 5.2 天（P = 0.02）。快速康复路径组的 30 天再入院率为 7.8%，而快速康复组为 2.0%（P = .04）。快速恢复组的 ICU 再入院率为 4.3%，而快速恢复组为 2.0% (P = .30)：总的来说，实施由 NP/PA 领导的心脏手术后 ICU 团队（快速康复路径）与相似的 ICU LoS、医院 LoS、ICU 再入院率、30 天再入院率相关，且没有不良事件或安全问题增加的显著信号。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Intensive Care Medicine CRITICAL CARE MEDICINE-

CiteScore

7.60

自引率

3.20%

发文量

107

期刊介绍： Journal of Intensive Care Medicine (JIC) is a peer-reviewed bi-monthly journal offering medical and surgical clinicians in adult and pediatric intensive care state-of-the-art, broad-based analytic reviews and updates, original articles, reports of large clinical series, techniques and procedures, topic-specific electronic resources, book reviews, and editorials on all aspects of intensive/critical/coronary care.