Rowan CM, Cristea AI, Hamilton JC, Taylor NM, Nitu ME, Ackerman VL. Nurse practitioner coverage is associated with a decrease in length of stay in a pediatric chronic ventilator dependent unit. World J Clin Pediatr 2016; 5(2): 191-197 [PMID: 27170929 DOI: 10.5409/wjcp.v5.i2.191]
Corresponding Author of This Article
Courtney M Rowan, MD, Assistant Professor, Department of Pediatrics, Section of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Dr., Phase 2 Room 4900, Indianapolis, IN 46202, United States. coujohns@iu.edu
Research Domain of This Article
Pediatrics
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Pediatr. May 8, 2016; 5(2): 191-197 Published online May 8, 2016. doi: 10.5409/wjcp.v5.i2.191
Nurse practitioner coverage is associated with a decrease in length of stay in a pediatric chronic ventilator dependent unit
Courtney M Rowan, A Ioana Cristea, Jennifer C Hamilton, Nicole M Taylor, Mara E Nitu, Veda L Ackerman
Courtney M Rowan, Jennifer C Hamilton, Mara E Nitu, Veda L Ackerman, Department of Pediatrics, Section of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN 46202, United States
A Ioana Cristea, Veda L Ackerman, Department of Pediatrics, Section of Pulmonology, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, Indianapolis, IN 46202, United States
Nicole M Taylor, Department of Psychology, University of Indianapolis, Indianapolis, IN 46227, United States
Author contributions: Rowan CM and Cristea AI collected the data; Taylor NM conducted the statistical analysis; Rowan CM drafted the first draft of the paper; the entire author group discussed the study design, reviewed the data analysis and critically reviewed and approved the manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Indiana University.
Informed consent statement: Patients were not required to give informed consent as the study was retrospective and all clinical patient data was de-identified before data analysis.
Conflict-of-interest statement: We have no conflict of interest or financial relationships to disclose.
Data sharing statement: Data was not shared amongst institutions.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Courtney M Rowan, MD, Assistant Professor, Department of Pediatrics, Section of Critical Care, Indiana University School of Medicine, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Dr., Phase 2 Room 4900, Indianapolis, IN 46202, United States. coujohns@iu.edu
Telephone: +1-317-9447065 Fax: +1-317-9443442
Received: January 29, 2016 Peer-review started: January 30, 2016 First decision: March 1, 2016 Revised: March 22, 2016 Accepted: April 7, 2016 Article in press: April 11, 2016 Published online: May 8, 2016 Processing time: 93 Days and 20.9 Hours
Abstract
AIM: To hypothesize a dedicated critical care nurse practitioner (NP) is associated with a decreased length of stay (LOS) from a pediatric chronic ventilator dependent unit (PCVDU).
METHODS: We retrospectively reviewed patients requiring care in the PCVDU from May 2001 through May 2011 comparing the 5 years prior to the 5 years post implementation of the critical care NP in 2005. LOS and room charges were obtained.
RESULTS: The average LOS decreased from a median of 55 d [interquartile range (IQR): 9.8-108.3] to a median of 12 (IQR: 4.0-41.0) with the implementation of a dedicated critical care NP (P < 1.0001). Post implementation of a dedicated NP, a savings of 25738049 in room charges was noted over 5 years.
CONCLUSION: Our data demonstrates a critical care NP coverage model in a PCVDU is associated with a significantly reduced LOS demonstrating that the NP is an efficient and likely cost-effective addition to a medically comprehensive service.
Core tip: This is a retrospective study to review the care of patients requiring care in the pediatric chronic ventilator dependent unit from May 2001 to May 2011 comparing the 5 years prior to the 5 years post implementation of the critical care nurse practitioner (NP) in 2005. The average length of stay decreased from a median of 55 d [interquartile range (IQR): 9.8-108.3] to a median of 12 (IQR: 4.0-41.0) with the implementation of a dedicated critical care NP (P < 0.0001). Post implementation of a dedicated NP, a savings of 25738049 in room charges was noted over 5 years.
