Comprehensive Trauma Patient Care by Nonphysician Providers
AACN Clinical Issues Advanced Practice in Acute & Critical CarePublished 1 August 2001
Mary Lou Sole, Ann Marie Hunkar-Huie, Jeannie Saul Schiller, Michael L. Cheatham
Citations20
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
An evaluation of a unique patient care service staffed by nonphysician providers designed to facilitate the management and long-term placement of trauma patients who no longer require intensive care while recovering from their injuries.
Abstract
Nonphysician providers are being increasingly used to care for trauma patients. As these complex patients recover, they require meticulous medical management and time-consuming psychosocial care. A retrospective evaluation of a unique patient care service staffed by nonphysician providers is presented. The Intermediate Care Service is designed to facilitate the management and long-term placement of trauma patients who no longer require intensive care while recovering from their injuries. The new diagnoses, physician order changes, and disposition of 93 patients cared for during a 6-month period are described. Most patients were admitted with neurologic injury. The most common new diagnosis was constipation; the most frequent new orders related to medications, including bowel management, and rehabilitation consultations. All patients were discharged from the hospital. The Intermediate Care Service represents a unique and valuable model for the collaborative management of complex trauma patients.
Keywords
MedicineHealth Professions
The Journal of Trauma: Injury, Infection, and Critical CareImproved Quality of Care and Reduction of Housestaff Workload Using Trauma Nurse Practitioners
128 Citations1990Johnese Spisso, CAROL OʼCALLAGHAN +2 more
The University of California, Davis, Medical Center introduced the use of nurse practitioners (NPs) to the trauma service in fiscal year 1986-87 to alleviate the increasing burdens placed on the surgical housestaff in their attempt to accommodate the rising patient volume and acuity.
PubMedCare activities and outcomes of patients cared for by acute care nurse practitioners, physician assistants, and resident physicians: a comparison.
116 Citations1998Ellen B. Rudy, Lynda J. Davidson +7 more
Journal of Advanced NursingA conceptual framework for evaluating the nurse practitioner role in acute care settings
108 Citations1999Souraya Sidani, D. Irvine
A conceptual framework for evaluating the ACNP role is proposed, an adaptation of the Nursing Role Effectiveness Model which was developed to facilitate the identification and investigation of nursing-sensitive outcomes.
American Journal of Critical CareCare activities and outcomes of patients cared for by acute care nurse practitioners, physician assistants, and resident physicians: a comparison
101 Citations1998Rudy Eb, LJ Davidson +7 more
The tasks and activities performed by acute care nurse practitioners and physician assistants are similar to those performed by resident physicians, however, residents treat patients who are sicker and older than those treated by acute Care Nurse Practitioners and Physicians.
Use of Physician Assistants as Surgery/Trauma House Staff at an American College of Surgeons-Verified Level II Trauma Center
80 Citations1998William R. Miller, Erich Riehl +3 more
The Hurley Medical Center trauma surgeon/physician assistant model is a viable alternative for verified trauma centers unable to maintain a surgical residency program and consistency and quality of care indicated by shortened length of stay is a hallmark of such a model providing the highestquality of care.
AACN Clinical Issues Advanced Practice in Acute & Critical CareAcute-Care Nurse Practitioners
54 Citations1997Ruth Kleinpell
Although long hours, resistance and uncertainty about the role, and perceived low salary exist, advantages identified reflect the role's autonomy, broad scope of practice, and contributions to collaborative care.
Image the Journal of Nursing ScholarshipTertiary Nurse Practitioners
52 Citations1993Anne Keane, Therese S. Richmond
Curricular imperatives and policy issues that will influence professional practice of the tertiary nurse practitioner are discussed.
AACN Clinical Issues Advanced Practice in Acute & Critical CareLongitudinal Survey of Acute Care Nurse Practitioner Practice: Year 2
30 Citations2001Ruth Kleinpell-Nowell
The role of the ACNP is progressing, and responses from 619 ACNPs 1 year after they sought national certification reveal continued role development and role challenges, along with increased independence, autonomy, and confidence in practice.
American Journal of PerinatologyTransition from Housestaff to Nonphysicians as Neonatal Intensive Care Providers: Cost, Impact on Revenue, and Quality of Care
30 Citations1995Marjorie Schulman, Katherine Lucchese +1 more
Nonphysician providers (NPP) increasingly fill roles traditionally performed by housestaff in a 26-bed neonatal intensive care unit, and revenue is minimally adversely affected, but access to NICU services and quality of care was preserved and in some cases enhanced with NPP.
PubMedNurse practitioners, cost savings, and improved patient care in the department of surgery.
30 Citations1996S C Hylka, Janice Cooper Beschle
The role of nurse practitioners and the impact of cost savings and improved care in one department of surgery are described.
AACN Clinical Issues Advanced Practice in Acute & Critical CareDemonstrating the Value of the Advanced Practice Nurse: An Evaluation Model
27 Citations1998Jacqueline Fowler Byers, Mary Lou Brunell
An evaluation model is presented that comprehensively measures the impact of advanced practice nurses on patients and families, and an example is presented to give credibility and validity to the APNs' positive impact on the quality and financial outcomes of care for each patient and for entire patient populations.
Clinical Nurse SpecialistAdvanced Practice Roles for Nurses in Tomorrow's Healthcare Systems
24 Citations1996Ann M. Berger, June G. Eilers +7 more
Seven advanced practice nurses roles clearly defined in terms of minimal qualifications and competencies critical to accomplishment of the duties, responsibilities, and expected outcomes are presented and comparison of competency requirements are presented.
Journal of the American Academy of Nurse PractitionersThe Acute Care Nurse Practitioner in Collaborative Practice
24 Citations1996Lynne Buchanan
This paper describes the development and evaluation of an alternative service based on a collaborative practice model and the role of nurse practitioners working under such a model and includes suggestions for process guideline development for organizations that want to improve collaborative practice relationships between unit nursing staff, nurse practitioners, and physicians.
Critical Care Nursing QuarterlyEvolving Role Descriptions of the Acute Care Nurse Practitioner
24 Citations1999Ruth Kleinpell
Medical Clinics of North AmericaTHE ROLE OF MIDLEVEL PROVIDERS IN CANCER SCREENING
23 Citations1996Cheryl Reed, Cynthia S. Selleck
Use of midlevel providers, who have already been shown to focus on health promotion and disease prevention, would be an effective way to provide quality, cost-effective cancer screening.
Dimensions of Critical Care NursingThe Critical Care Nurse Practitioner
20 Citations1996Rosalyn J. Watts, Mary Jane S. Hanson +3 more
This paper gives a historical perspective and describes the current national need for CCNPs to practice in expanded roles both within and outside the boundaries of intensive care.
AACN Clinical Issues Advanced Practice in Acute & Critical CareAn Evaluation of the Role and Practices of the Acute-Care Nurse Practitioner
17 Citations1997Helen Stupak Shah, Kathleen A. Bruttomesso +2 more
Evaluation data from a small number of individuals on a learning curve from students to novice practitioners show that self-efficacy increases with clinical experience, whereas clinical reasoning and technical competency are challenging to beginning practitioners.
AACN Clinical Issues Advanced Practice in Acute & Critical CareLongitudinal Survey of Acute Care Nurse Practitioner Practice: Yearl
17 Citations1999Ruth Kleinpell-Nowell
Responses from 545 ACNPs 2 years after national certification reveal continued development and challenges in practice, and role components continue to highlight the comprehensive care model of ACNP practice.
AACN Clinical Issues Advanced Practice in Acute & Critical CareMeasuring Advanced Practice Nursing Outcomes
16 Citations1999Ruth Kleinpell-Nowell, Teresa M. Weiner
An overview of advanced practice nursing outcomes research is presented, outcome measures important to advanced practice nurses (APNs) are reviewed, and sources of outcome measures and instruments that can be used by APNs to establish the effectiveness of the role are discussed.
AACN Clinical Issues Advanced Practice in Acute & Critical CareThe Changing Role of Advanced Practice Nursing In a Managed Care Environment
14 Citations1996Mary Beth Parr
The author reviews the impact managed care has had on the roles of two master's-prepared traditional clinical nurse specialists and demonstrates that advanced practice nurses can have a valuable role in the managed care environment.
PubMedThe advanced practice nurse in an acute care setting. The nurse practitioner in adult cardiac surgery care.
12 Citations1996Mark Callahan
An Adult Cardiac Surgery program in New York City uses acute care nurse practitioners in providing patient care through the hospital course, exploring one such practice.
AACN Clinical Issues Advanced Practice in Acute & Critical CareCurrent Questions With Regard to Acute Care Nurse Practitioner Preparation and Role Implementation
12 Citations1996Marilyn Hravnak, Margaret Q. Rosenzweing +1 more
The role of the acute care nurse practitioner is being implemented in acute and tertiary care settings and questions arise, including whether a need for the role has been clearly established and the adequacy of educational preparation.
AACN Clinical Issues Advanced Practice in Acute & Critical CareManaged Care
9 Citations1997Rebecca Anderson
Through case management and direct acute-care patient management, acute-Care nurse practitioners (ACNPs) may ultimately contribute to reductions in hospitalization costs and must be measured against their invaluable contributions to increased quality of care.
PubMedAdvancing nursing practice: acute care nurse practitioners meet challenges at and beyond the health care horizon.
9 Citations1996Eleanor F. Bond, Diana J. Wilkie +3 more
Health care market factors fostering ACNP practice, AC NP practice domain, the University of Washington ACNP program, and collaborative contributions from educators, care providers, professional organizations, and regulatory groups needed to implement the role are described.