Nurse Practitioners and Interdisciplinary Teams in Pediatric Critical Care

Gigli, Kristin Hittle; Dietrich, Mary S.; Buerhaus, Peter I.; Minnick, Ann F.

doi:10.4037/aacnacc2018588

Cited by 10 publications

(6 citation statements)

References 31 publications

(30 reference statements)

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“…The lack of an association between SSOP and NPs’ clinical roles could be explained by several factors. PICUs rely extensively on team-based care which integrates NPs as members of the interprofessional teams (Gigli et al., 2018a). As teams collaboratively provide care to a group of patients, the census of a PICU, local culture, and team configurations can exert greater influence on the NP role than the regulatory environment (Poghosyan, 2018).…”

Section: Discussionmentioning

confidence: 99%

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Implications of State Scope-of-Practice Regulations for Pediatric Intensive Care Unit Nurse Practitioner Roles

Gigli

Martsolf

2021

Policy, Politics, & Nursing Practice

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Nurse practitioner (NP) advocacy efforts often focus on attaining full practice authority. While the effects of full practice authority in primary care are well described, implications for hospital-based NPs are less clear and may differ because of hospitals’ team-based care and administrative structure. This study examines associations between state scope-of-practice (SSOP) and clinical roles of hospital-based pediatric intensive care unit (PICU) NPs. We conducted a national survey to assess clinical roles of PICU NPs including daily patient care, procedural, and consultation responsibilities as well as hospital-level administrative oversight practices. We classified SSOP as full or limited (reduced or restricted SSOP) practice. We present descriptive statistics and evaluate differences in clinical roles and hospital-level administrative oversight based on SSOP. The final sample included 55 medical directors and 58 lead (senior or supervisory) NPs from 93 of the 140 (66.4%) PICUs with NPs. There were no significant differences in daily patient care, procedural, or consultation responsibilities based on SSOP ( p > .05). However, NPs in full practice authority states were more likely to bill for care than those in limited practice states (66.7% vs. 31.8%, p = .003), while those in limited practice states were more likely to report to advanced practice managers (36.7% vs. 13%, p = .03). For PICU NPs, SSOP was not associated with variation in clinical responsibilities; conversely, there were differences in billing and reporting practices. Future work is needed to understand implications of variation in hospital-level administrative oversight.

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Section: Discussionmentioning

confidence: 99%

“…SSOP regulations determine the degree to which an NP requires physician supervision. However, in hospital-based settings with team-based care, like the PICU, the team always includes physicians (Gigli et al., 2018a). The differences in the degree of physician supervision may be less burdensome to practice and role actualization.…”

Section: Discussionmentioning

confidence: 99%

Implications of State Scope-of-Practice Regulations for Pediatric Intensive Care Unit Nurse Practitioner Roles

Gigli

Martsolf

2021

Policy, Politics, & Nursing Practice

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“…Although there are an increasing number of APPs providing patient care, many health care systems struggle with how to best utilize these providers to achieve high-value care (Anen & McElroy, 2017; Gigli et al, 2018; Hurlock-Chorostecki & McCallum, 2016). A focused effort assessing the effectiveness of APP utilization within care teams can lead to better planning at the department level.…”

Section: App Practice Modelsmentioning

confidence: 99%

Advanced Practice Provider Care Team Models

Chaney

Beliles

Keimig

et al. 2022

Journal of Ambulatory Care Management

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Health care leaders must be innovative to meet the demands of patient access and cost efficiency, all while never compromising patient safety or experience. A clear understanding of the care team model with optimal utilization of all team members is paramount to success. This article discusses 5 nurse practitioner and physician assistant (collectively called advanced practice providers) care team models that regularly occur in health care organizations across the country. Examples of each practice model, a discussion on when each model would be appropriate, as well as data on patient experience and financial return of investment of each model are provided.

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“…This inadequate adoption permits employers to hire NPs into positions for which their certification is not aligned. Recent surveys found that three quarters of those responsible for hiring, credentialing, and privileging hospitalist NPs were unaware of the Consensus Model (Klein, Kaplan, Stanik-Hutt, Cote, & Brooks, 2020) and a minority of hospitals require NP acute care certification to care for acutely or critically ill patients (Gigli, Dietrich, Buerhaus, & Minnick, 2018;Klein et al, 2020). However, the majority of NPs in such positions perform bedside procedures that are only addressed in the educational standards for acute care NPs (National Task Force on Quality Nurse Practitioner Education, 2016).…”

Section: Introductionmentioning

confidence: 99%