Critical Care Nurse Practitioners Improve Compliance With Clinical Practice Guidelines in “Semiclosed” Surgical Intensive Care Unit

Abstract

This prospective study examined whether the integration of acute care nurse practitioners (ACNP) in a "semiclosed" surgical intensive care unit (SICU) model increased compliance with clinical practice guidelines (CPG). Patients were admitted to critical care services with a (a) "semiclosed"/ACNP team or (b) "mandatory consultation"/non-ACNP team. CPG compliance was significantly higher (P < .05) on the "semiclosed"/ACNP team for all 3 CPGs examined in the study.

The Effects of Advanced Practice Nurses (APNs) as Intensivists in a Surgical Intensive Care Unit (SICU) on Patient Outcomes, Healthcare Charges, and APN Intensivist Services in the SICU

“…These interventions have been discussed in the previous sections of this chapter (see pages 55 to 94). Care provided by APNs has been documented in numerous studies examining quality of care (Kleinpell & Gawlinski, 2005), morbidity and mortality (Gracias et al, 2008;Hoffman et al, 2005;Munro & Taylor-Panek, 2007;Russell et al, 2002;Sole et al, 2001;Burns et al, 2003;Meyer & Miers, 2005). The results of these studies indicate that the quality of care provided by APNs may be equal to physicians as well as cost efficient (Horrocks et al, 2002;Kinnersley et al, 2000).…”

“…Several other studies have documented the role of APNs in different practice areas providing high quality care and low cost thus benefitting the patient, provider, and healthcare system (Brooten et al, 1986(Brooten et al, , 1994(Brooten et al, , 2002Hoffman, Tasota, Zullo, Scharfenberg, & Donahoe, 2005;Kleinpell, 2005;Rudy et al, 1998;Sidani et al, 2006;Spisso, O'Callaghan, McKennan, & Holcroft, 1990). Care provided by APNs in acute care has been documented in numerous studies examining quality of care, (Kleinpell & Gawlinski, 2005), morbidity, and mortality (Gracias et al, 2008;Hoffman et al, 2005;Munro & Taylor-Panek, 2007;Russell, VorderBruegge, & Burns, 2002;Sole, Hunkar-Huie, Schiller, & Cheatham, 2001;Burns et al, 2003;Meyer & Miers, 2005). Results of these studies have indicated that the quality of care provided by APNs is equal to that of physicians as well as being cost efficient (Horrocks, Anderson, & Salisbury, 2002;Kinnersley et al, 2000).…”

Impact of the opening of a specialized cardiac surgery recovery unit on postoperative outcomes in an academic health sciences centre

“…In addition, an acute care nurse practitioner joined the CSRU team at the beginning of year 2 of the study, whereas no nurse practitioner had worked in the medical-surgical ICU at the receiving institution prior to merger. Preliminary studies have shown that the involvement of advanced practice nurse practitioners was associated with enhanced compliance to clinical practice guidelines, 13 as well as the promotion of better continuity of care and collaboration amongst health care providers. 14 Furthermore, the medical directive empowering CSRU nurses and respiratory therapists to wean patients from the ventilator when hemodynamic status and respiratory function were stable, may have had other benefits in addition to a modest reduction in postoperative ventilator hours.…”

Competing Priorities in the Brain Injured Patient: Dealing with the Unexpected

“…The achievement of these goals requires that trauma teams work efficiently, utilizing protocolized care and well-functioning clinical surveillance systems. 74,75 The overall goal of the trauma healthcare team is to reconcile any conflicting priorities with the goal of maximizing the outcome from the perspective of the "whole patient". The present two volume book "Brain Injury" is distinctive in its presentation and includes a wealth of updated information on many aspects in the field of brain injury.…”