ABSTRACT
Objective: This study evaluated the effects of interprofessional conferences on intensive care units (ICUs) by comparing related outcomes before and after their introduction. Patients and Methods: This study was conducted at a single center and included ICU patients admitted between April 2017 and March 2019. Interprofessional conferences include physicians, nurses, physical therapists, nutritionists, and pharmacists. Data were extracted from the available medical records. The primary outcome measure was ICU length of stay (LOS). The secondary outcome measures were hospital LOS and any rehabilitation and nutrition begun within 48 hours of ICU admission. Outcomes before and after the introduction of the interprofessional conferences were compared. The adjusted variables were sex, age, body mass index, ICU readmission, health outcomes, Barthel index at admission, and disease (classified according to the International Statistical Classification of Diseases and Related Health Problems 10th edition). Results: We included 1,765 ICU patients admitted between April 2017 and March 2019. There were 898 patients in the "pre-interprofessional conference introduction" group (before group) and 867 in the "post-interprofessional conference introduction" group (after group). The ICU LOS (regression coefficient: -0.08; 95% confidence interval [CI]: -0.13 to -0.04) and hospital LOS (regression coefficient: -2.96; 95% CI: -5.20 to -0.72) were significantly shorter in the after group. Moreover, the proportion of patients who commenced nutrition (odds ratio [OR]: 1.45; 95% CI: 1.14 to 1.84) and rehabilitation (OR: 0.77; 95% CI: 0.51 to 1.17) within 48 hours of ICU admission was significantly higher in the after group. Conclusions: Introduction of interprofessional conferences effectively reduced ICU and hospital LOSs and improved likelihood of commencing nutrition and rehabilitation within 48 hours of ICU admission.
ABSTRACT
AIM: We compared Japan nurse practitioner-led care and physician trainee-led care in terms of patients' length of stay in a secondary emergency department in Japan. METHODS: This was a retrospective observational study, utilizing medical records. Participants (n = 1419; mean age = 63.9 ± 23.4 years; 52.3% men) were patients transferred to the emergency department by ambulance between April 2016 and March 2018 in western Tokyo. Multiple linear regression analyses were performed, with length of stay as the dependent variable and factors related to the length of stay, including medical care leaders, as the independent variable. RESULTS: Approximately half of the patients (n = 763; 53.8%) received Japan nurse practitioner-led care. Patients' length of stay was significantly shorter, by 6 min, in the Japan nurse practitioner-led care group, compared with the physician trainee-led care group (unstandardized coefficient: -6.81; 95% confidence interval: -13.35 to -0.26; p < 0.05). CONCLUSION: Patients' shorter length of stay in the Japan nurse practitioner group, compared with the physician trainee group, suggests that Japan nurse practitioners are not inferior to physician trainees in terms of the time spent to manage patients.