Patient-care time allocation by nurse practitioners and physician assistants in the intensive care unit.

Critical Care : the Official Journal of the Critical Care Forum
David L CarpenterCraig M Coopersmith

Abstract

Use of nurse practitioners and physician assistants ("affiliates") is increasing significantly in the intensive care unit (ICU). Despite this, few data exist on how affiliates allocate their time in the ICU. The purpose of this study was to understand the allocation of affiliate time into patient-care and non-patient-care activity, further dividing the time devoted to patient care into billable service and equally important but nonbillable care. We conducted a quasi experimental study in seven ICUs in an academic hospital and a hybrid academic/community hospital. After a period of self-reporting, a one-time monetary incentive of $2,500 was offered to 39 affiliates in each ICU in which every affiliate documented greater than 75% of their time devoted to patient care over a 6-month period in an effort to understand how affiliates allocated their time throughout a shift. Documentation included billable time (critical care, evaluation and management, procedures) and a new category ("zero charge time"), which facilitated record keeping of other patient-care activities. At baseline, no ICUs had documentation of 75% patient-care time by all of its affiliates. In the 6 months in which reporting was tied to a group incentive, six of sev...Continue Reading

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Citations

Jan 21, 2014·Critical Care : the Official Journal of the Critical Care Forum·Abhijit Duggal, Gordon Rubenfeld
Mar 13, 2014·Journal of the American Medical Informatics Association : JAMIA·Thomas G KannampallilAmy Franklin
Jan 31, 2016·Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates·Allison Salk, Eli D Ehrenpreis
Aug 26, 2015·Clinics in Chest Medicine·Steven A Fuhrman, Craig M Lilly
Apr 10, 2018·Critical Care Medicine·Dan Stieper KarbingCarlo Alberto Volta
Jan 29, 2019·Critical Care Medicine·Stephen M PastoresUNKNOWN Academic Leaders in Critical Care Medicine (ALCCM) Task Force of the Society of the Critical Care Medicine
Oct 16, 2015·Critical Care Medicine·David L CarpenterCraig M Coopersmith
Aug 23, 2018·Nursing in Critical Care

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