Nurse practitioners, physician assistants linked to higher ICU survival rates

the Clinical Advisor take:

Intensive care teams with nurse practitioners and physician assistants have been linked to increased survival among intensive care patients, compared with teams comprising solely of resident physicians, results of a study presented at the Society of Critical Care Medicine meeting suggest.

"Our findings suggest the partnership of physician assistants (PAs) and acute care nurse practitioners (NPs) with pulmonary and critical care physicians and fellows can improve outcomes in the medical intensive care unit (ICU) and help alleviate the projected shortage of bedside intensivists," Joe Keller, PA-C, of the Cleveland Clinic in Ohio, told attendees at the oral abstract session.

To determine the impact of health outcomes in ICU patients cared for by teams comprised of NPs and PAs, Joe Keller, PA-C, of the Cleveland Clinic in Ohio, and colleagues analyzed data from 1,054 patients admitted to the two 10-and 11-bed study ICUs from July 2013 to April 2014.

The survival rate among intensive care patients cared for by a PA and acute care NP was 92.2% compared with 88.6% among those cared for by a team of residents (P=0.047), with all over staffing and resources equal. The length of stay, readmission, and hospital-acquired infection rates were comparable between the groups, noted the investigators.

In the ICUs studied, NPs and PAs averaged 1.8 years of  ICU-specific experience, whereas medical residents spent only a small amount of time in the ICU, Keller told MedPage Today.

"A nurse practitioner has done something 500 times versus a resident who is training and learning how to do something, who would you think is more experienced?"