Outcomes of care managed by an acute care nurse practitioner/attending physician team in a subacute medical intensive care unit
Many academic medical centers employ nurse practitioners as substitutes to provide care normally supplied by house staff. To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an...
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| Veröffentlicht in: | American journal of critical care 2005-03, Vol.14 (2), p.121-130 |
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| container_title | American journal of critical care |
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| creator | Hoffman, Leslie A Tasota, Frederick J Zullo, Thomas G Scharfenberg, Carmella Donahoe, Michael P |
| description | Many academic medical centers employ nurse practitioners as substitutes to provide care normally supplied by house staff.
To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.
During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.
Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).
In a subacute intensive care unit, management by the 2 teams produced equivalent outcomes. |
| doi_str_mv | 10.4037/ajcc2005.14.2.121 |
| format | Article |
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To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.
During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.
Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).
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To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.
During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.
Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).
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To compare outcomes in a subacute medical intensive care unit of patients managed by a team consisting of either an acute care nurse practitioner and an attending physician or an attending physician and critical care/pulmonary fellows.
During a 31-month period, in 7-month blocks of time, 526 consecutive patients admitted to the unit for more than 24 hours were managed by one or the other of the teams. Patients managed by the 2 teams were compared for a variety of outcomes.
Patients managed by the 2 teams did not differ significantly for any workload, demographic, or medical condition variable. The patients also did not differ in readmission to the high acuity unit (P = .25) or subacute unit (P = .44) within 72 hours of discharge or in mortality with (P = .25) or without (P = .89) treatment limitations. Among patients who had multiple weaning trials, patients managed by the 2 teams did not differ in length of stay in the subacute unit (P = .42), duration of mechanical ventilation (P = .18), weaning status at time of discharge from the unit (P = .80), or disposition (P = .28). Acute Physiology Scores were significantly different over time (P = .046). Patients managed by the fellows had more reintubations (P=.02).
In a subacute intensive care unit, management by the 2 teams produced equivalent outcomes.</abstract><cop>United States</cop><pub>American Association of Critical-Care Nurses</pub><pmid>15728954</pmid><doi>10.4037/ajcc2005.14.2.121</doi><tpages>10</tpages></addata></record> |
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| identifier | ISSN: 1062-3264 |
| ispartof | American journal of critical care, 2005-03, Vol.14 (2), p.121-130 |
| issn | 1062-3264 1937-710X |
| language | eng |
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| source | MEDLINE; Journals@Ovid Complete |
| subjects | Aged Care and treatment Education, Continuing Evaluation Female Hospitals, Teaching Humans Intensive care nursing Intensive Care Units - organization & administration Length of Stay Male Medical Staff, Hospital Middle Aged Nurse Practitioners Nursing Outcome Assessment (Health Care) Patient Care Team Patients Physicians Practice Respiration, Artificial United States |
| title | Outcomes of care managed by an acute care nurse practitioner/attending physician team in a subacute medical intensive care unit |
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