Utilizing Trauma Nurse Practitioners to Decrease Length of Stay

Abstract

This article describes a nurse practitioner model utilized to decrease the length of stay and improve the quality of discharge planning for hospitalized trauma patients between 1999 and 2006. An observational method employing nurse practitioners to decrease length of stay for the trauma population during these years is described. Adding nurse practitioners to the trauma team has resulted in decreasing the length of stay in all 4 of the injury severity score groups. Adding nurse practitioners to the trauma team provides a core member in a revolving trauma service. Consequently, length of stay and discharge planning have been positively impacted.

Fifty ways to reduce length of stay: An inventory of how hospital staff would reduce the length of stay in their hospital

“…And in addition treating patients in a joint care programme [42,43] • Surgical pre-assessment, planning the admission, post-operative care and planning a safe discharge [44], early imaging with CT, MRI, or nuclear scintigraphy, particularly on the day before or the day of admission [45] • Preventing admissions of patients not needing inpatient care [46][47][48] • Utilising specialised nurse practitioners or other advanced professionals [49][50][51] • Creating an observation unit that gives more time to decide whether or not to admit the patient [52] • Stimulating that patients initially are seen by the right specialty [53] • Performing same-day major surgery [47] • Optimising guidelines and protocols or introducing clinical pathways for specific patient groups in order to reduce the length of stay and often with improvements of quality of care • Treating patients in a fast-track or accelerated care programme [54][55][56][57][58][59][60][61][62] • Choosing a laparoscopic rather than a classic intervention (open surgery) [63][64][65][66][67][68][69][70] although readmission rates for laparoscopic treatment may be higher [71] • Implementing an acute stroke unit [72] • Being aware that consultations, transfers and fragmentation of care often lead to delays [73,74] • Reducing waiting times for examinations [8,48] • Stimulating early rehabilitation and physical activity [75]…”

Impact of Hospital-Employed Physician Assistants on a Level II Community-Based Orthopaedic Trauma System

“…9,12,14,15 In orthopedics, length of stay is often delayed by durable medical equipment delivery such as crutches or walkers. 9,12,14,15 In orthopedics, length of stay is often delayed by durable medical equipment delivery such as crutches or walkers.…”

Acute Care Nurse Practitioners in Trauma Care

“…At first consideration, this indicates a high level of expertise and experience to the benefit of trauma patients. [14][15][16][17][18][19] Trauma ACNPs have been shown to improve patient care in areas such as reduced incidence of urinary tract infections, 15 reduced complication rate, 13 and increased identification of missed injuries 20 and deep vein thrombosis. This circumstance may be tied to the relationship between trauma care and acute care surgery for the benefit of surgeons who may have less operative opportunity on a dedicated trauma service.…”