Mortality, length of stay, and discharge destination are not affected by ICU staffing type
WEDNESDAY, June 8 (HealthDay News) -- An acute care team comprised of nonphysicians can provide critical care to severely ill patients in a medical intensive care unit (MICU) with no significant difference in clinical outcomes when compared with a traditional, house staff-based team, according to a study published in the June issue of Chest.
Hayley B. Gershengorn, M.D., from Beth Israel Medical Center in New York City, and colleagues compared the impact of use of nonphysician provider-based teams with those of medical house staff-based teams on patient outcomes, for 590 daytime admissions to two MICUs. One MICU with 302 admissions had nurse practitioners and physician assistants during the day (7 a.m. to 7 p.m.) and an attending physician covering the night. The other MICU with 288 admissions had medicine residents covering 24 hours a day. Hospital mortality, length of stay (LOS) in the MICU and hospital, and post-hospital discharge destination were the outcomes studied.
The investigators found that the two MICUs had similar predicted mortality (mortality probability model III) and no significant difference in hospital mortality, MICU LOS, or hospital LOS. Rates of discharge to a skilled care facility were also similar. After adjusting for multiple variables, the type of staffing in the MICU was not correlated with hospital mortality, MICU LOS, hospital LOS, or post-hospital discharge destination.
"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," the authors write.
Abstract
Full Text (subscription or payment may be required)