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Mortality Not Up at Nurse-Practitioner-Staffed ICU

No increase in ICU mortality, in-hospital mortality compared with resident-staffed ICU admissions

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MONDAY, Oct. 17, 2016 (HealthDay News) -- Admission to a nurse-practitioner-staffed medical intensive care unit (ICU) is not associated with increased mortality compared with admission to a resident-staffed medical ICU, according to a study published online Sept. 14 in Critical Care Medicine.

Rachel Scherzer, M.S.N., R.N., from Thomas Jefferson University in Philadelphia, and colleagues conducted a retrospective chart review of 1,157 medical ICU admissions at a large urban academic university hospital. The admissions included 221 nurse-practitioner-staffed medical ICU admissions (19.1 percent) and 936 resident-staffed medical ICU admissions (80.9 percent). Primary outcomes, including ICU mortality, in-hospital mortality, medical ICU length of stay, and post-ICU discharge hospital length of stay, were compared between the groups.

The researchers found that patients admitted to the nurse-practitioner-staffed medical ICU were older, were more likely to be transferred from an inpatient unit, and had a higher severity of illness by relative expected mortality. The primary outcomes did not differ apart from medical ICU length of stay, which was significantly longer for nurse-practitioner-staffed ICUs. The nurse practitioner ICU also had higher post-hospital discharge to a non-home location.

"We found no difference in mortality between a nurse-practitioner-staffed medical ICU and a resident-staffed physician medical ICU," the authors write. "Our study adds further evidence that advanced practice providers can render safe and effective ICU care."

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