Your browser doesn't support javascript.
loading
Impact of advanced practice providers (nurse practitioners and physician assistants) on surgical residents' critical care experience.
Kahn, Steven A; Davis, Sarah A; Banes, Caroline T; Dennis, Bradley M; May, Addison K; Gunter, Oliver D.
Afiliação
  • Kahn SA; Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: Steven.A.Kahn@vanderbilt.edu.
  • Davis SA; Department of Anesthesiology, Surgical Intensive Care Unit, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Banes CT; Department of Anesthesiology, Surgical Intensive Care Unit, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Dennis BM; Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
  • May AK; Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
  • Gunter OD; Division of Trauma and Surgical Critical Care, Department of Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.
J Surg Res ; 199(1): 7-12, 2015 Nov.
Article em En | MEDLINE | ID: mdl-26173380
ABSTRACT

BACKGROUND:

Teaching hospitals often employ advanced practice providers (nurse practitioners and physician assistants or APPs) to counteract residents' work-hour restrictions. With increased utilization of APPs in labor-intense areas, such as intensive care units (ICUs), APPs may have an impact on resident education and experience. No studies have investigated the direct role an APP plays on the training experience of a surgical resident in the ICU. MATERIALS AND

METHODS:

An institutional review board-approved survey was emailed to residents in Accreditation Council for Graduate Medical Education-accredited general surgery programs. Surveys asked about demographics, residency and/or ICU characteristics, and the effects of APPs on patient care, workflow, and educational experience. Regression analysis determined predictors of resident perception.

RESULTS:

A total of 354 of 1178 residents responded to the survey (30%). Some residents felt that nurses calling APPs preferentially for patient-care issues interfered with education (17%) and residents' ability to follow patients (12%) and was associated with overall detrimental effects to ICU experience on regression (odds ratio, 3.7; confidence interval, 1.5-9.1). Most residents reported positive effects of APPs, such as reduced resident workload (79.8%), teaching protocols and/or guidelines (60.3%), enhanced patient care (60.3%), and enhanced communication (50.5%). When asked how APPs affected their overall ICU experience, 48.4% reported positive effects, 20.6% reported "no effect," and 31% reported detrimental effects.

CONCLUSIONS:

Only a minority of residents perceived that APPs detract from training, particularly those who felt excluded when nurses preferentially contact APPs with patient-care issues. APPs have the potential to enhance training and ICU experience, as reflected in many of the responses. Strategies to maintain direct nurse and resident communication might preserve residents' perception of the educational value of APPs.
Assuntos
Palavras-chave

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Assistentes Médicos / Cirurgia Geral / Atitude do Pessoal de Saúde / Cuidados Críticos / Internato e Residência / Profissionais de Enfermagem Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Surg Res Ano de publicação: 2015 Tipo de documento: Article

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Assistentes Médicos / Cirurgia Geral / Atitude do Pessoal de Saúde / Cuidados Críticos / Internato e Residência / Profissionais de Enfermagem Tipo de estudo: Guideline / Prognostic_studies / Qualitative_research / Risk_factors_studies Limite: Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: J Surg Res Ano de publicação: 2015 Tipo de documento: Article