Abstract
Certified Nurse Specialists (CNS) are advanced practice nurses that often play a role in management. This study aims to investigate whether cooperation between CNSs in the position of Intensive Care Unit (ICU) head nurse and intensivists change the length of stay for ICU patients. A single centered retrospective cohort study design was followed. A multivariable regression analysis was performed to determine whether there is a difference in patients’ length of ICU stay for two years before and after CNS as ICU head nurse and an intensivist started collaborating. The patients’ diagnosis, age, gender, scheduled/emergency admission, surgical history, length of ICU stay, usage of ventilator, and details of ICU treatment were collected from the institution’s electronic medical records. During the study period (April 2015 to March 2019), 3,135 patients were admitted to ICU, with 1,471 in the before collaboration group and 1,664 in the after-collaboration group. Collaboration between the CNS as head nurse and intensivists was significantly associated with shorter length of ICU stay (coefficient -0.03 [95% CI, -0.05–0.01], p < 0.001, t-statistic -3.29). Our main finding illustrates that in low-intensity ICUs, collaboration between CNSs as head nurses and intensivists may reduce patients’ length of ICU stay.
Highlights
A low-intensity ICU employs a system in which only doctors in each medical department treat patients in the Intensive Care Unit (ICU) and intensivists get involved only at the request of the attending physician or surgeon. [1] In such ICUs, collaboration between the attending physician, intensivists, the ICU nurse, and other actors is vital
The aim of this study is to investigate whether Certified Nurse Specialists (CNS) as head nurses can work with intensivists to make changes to patients’ length of stay in low-intensity ICUs
The system of providing medical care in the ICU was changed from a system in which each department provided medical care by itself to a system in which the attending physician consulted with the intensivists when necessary. [11] Prior to the introduction of elective care consultations, the CNS would discuss issues related to the treatment plan and the patient’s background with the primary physician and make prior arrangements to facilitate the intervention of the intensivists
Summary
A low-intensity ICU employs a system in which only doctors in each medical department treat patients in the Intensive Care Unit (ICU) and intensivists get involved only at the request of the attending physician or surgeon. [1] In such ICUs, collaboration between the attending physician, intensivists, the ICU nurse, and other actors is vital. The Advanced Practice Nurse (APN) plays a significant role in intensive care, improving bedside care, consultation, and ethical coordination. CNS and intensivist collaboration’s efforts on patients’ length of ICU stay The Advanced Practice Nurse (APN) plays a significant role in intensive care, improving bedside care, consultation, and ethical coordination. [2,3,4,5,6,7]
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