Abstract
Nurse practitioners are increasingly now members of intensive care teams in Japan, but no data exist about their effect on the outcomes for critically ill patients. This study aimed to compare the outcomes of postoperative patients on mechanical ventilators before and after the participation of nurse practitioners in intensive care teams. We retrospectively identified 387 patients who underwent postoperative mechanical ventilation at a University Hospital in Japan, using data from medical records from 1 April 2015 to 31 March 2017. We extracted data and compared patients’ length of stay in the intensive care unit and the hospital, mechanical ventilation days, postoperative rehabilitation start date, rehabilitation prescription, intensive care unit and hospital mortality, and intensive care unit readmission. Multiple regression analysis was used to analyze the factors affecting length of stay in the intensive care unit. Patients who received care from nurse practitioners and physicians had significantly shorter stays in intensive care (4.8 ± 4.8 days versus 6.7 ± 10.3 days, p < 0.021). Mechanical ventilation days, total length of hospital stay, rehabilitation prescription, mortality in intensive care and hospital, and readmission to intensive care were all similar to those who received care only from physicians. The multiple regression analysis suggests that participation of nurse practitioners in intensive care reduced the length of stay in the unit by 2.6 days (p = 0.003). These findings could help to increase use of non-physician healthcare providers in intensive care. Our results demonstrated that it is both effective and safe for nurse practitioners to participate in intensive care teams that provide care for postoperative patients receiving mechanical ventilation.
Highlights
Nurse practitioners (NPs) have been recognized to have an important role in providing healthcare [1, 2]
During the two-year study period, 399 postoperative patients requiring mechanical ventilation were admitted to the intensive care units (ICUs)
P value 0.162 0.003 0.012 0.283 0.003. In this retrospective study of postoperative patients on mechanical ventilators, we found that nurse practitioners (NPs) participation in the ICU team was associated with reduced ICU length of stay, but it is unclear whether the association was directly causal
Summary
Nurse practitioners (NPs) have been recognized to have an important role in providing healthcare [1, 2]. Their roles have been increasing in intensive care settings that need interprofessional teams providing collaborative healthcare. In the United States, there are 270,000 certified NPs [3]. NP education has been provided at Master’s level in Japan since 2008 [9]. Those who want to become NPs in Japan take a graduate course after gaining five years of clinical experience. NPs are increasingly employed to provide healthcare, but there are no data to demonstrate the effect on patient outcomes
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