ICU Outcomes No Different Without Physician Staffing

Reprint from Nurse.com (Wednesday June 8, 2011)

With ICUs facing staff shortages that are predicted to worsen in the future, a recent study suggests that non-physician providers can help address these deficits.

The study by physicians from Beth Israel Medical Center and Columbia University Medical Center in New York City found no significant differences in hospital mortality or other patient outcomes between high-acuity, adult ICUs staffed by nurse practitioners and physician assistants when compared with those staffed by intensivists or other physicians.

The study included a retrospective review of 590 daytime (7 a.m. to 7 p.m.) admissions to two ICUs at one hospital. Nurse practitioners and physician assistants staffed one of the ICUs during the day, with attending physician coverage overnight. In the other ICU, medical residents were present around the clock.

In addition to patient mortality, the researchers found no significant difference between the two ICUs in ICU length of stay and hospital length of stay. Discharge to a skilled care facility, as opposed to home, also was similar after adjusting for other factors.

The researchers noted that as “the number of ICU beds and demand for intensivists increase, alternative solutions are needed to provide coverage for critically ill patients.”

“Staffing models including daytime use of nonphysician providers appear to be a safe and effective alternative to the traditional house staff-based team in a high-acuity, adult ICU,” they concluded.