Ruth M. Kleinpell and Robert Grabenkort, the authors of the article under consideration, tell that nursing practitioners and physician assistants play a very important role in the intensive care unit, however, their participation is still not well known to the public. This is why the authors aim at indentifying and using different literature sources concerning advanced practitioners in acute care settings by means of nonquantitative methods. One more purpose of this article was to describe possible implications for future critical care practice and improve nursing care within different critical care settings.
In order to conduct this very research, the authors reviewed more than 145 articles and used PubMed, Cumulative Index to Nursing and Allied Health Literature database, and some other services. The searching were limited from 1996 to 2007. Such terms like nurse practitioners, physician assistants, acute care nurse practitioner, intensive and critical care, and midlevel provider were combined in order to find out the necessary information, reliable articles, and other appropriate sources. The major point is that sources published not on English were excluded because abstracts and studies were not published.
31 research studies mostly focused on the role of both nurse practitioners and physician assistants in the care of critically ill patients. To be more exactly, 5 sources were devoted to physician assistance care; 20 sources are all about nursing practitioner care only; and 6 sources presented reliable information about NP and PA, their cooperation, and common impact on care of ill patients. All information was classified according to such categories as education, narrative interviews, and research studies. The vast majority of the sources found concentrated on “the impact of care on patient care management.” (Kleinpell and Grabenkort, 2008).
The included studies were sufficiently valid for the topic under consideration. The idea of nurse practitioners and physician assistants’ care, their role and influence into the sphere of medicine and nursing in particular was perfectly described within this article. Several studies described the models of care from nurse practitioners and physician assistants’ sides; some of them present a clear picture of how patient care management influence the development of the chosen sphere. According to these studies, PA and NP care was closely connected to clinical and financial outcomes “for mechanically ventilated patients including ventilator duration, LOS, morality and cost savings, reduction in floor…” (Kleinpell and Grabenkort, 2008).
Of course, certain studies present quite different information on one and the same question, because any scientist has his/her own vision on the problem and presents various ways out to solve it. However, the studies, chosen for consideration, have a lot in common. As the studies were classified, the sources of the same group present homogenous information about patient care management. The sources of other groups cover the same topic, but concentrate on other heterogeneous details in order to analyze the topic properly from different perspectives.
The results of the research conducted are rather impressive. With the help of 31 studies, which analyze NP and PA care in critical care settings, it was proved that patient care management, education of patients, and reinforcement of practice guidelines play considerable roles in the development of the care of such type. 14 sources introduce the information about intensive care unit, and only 14 are about acute care. However, this information is enough to make sound conclusions and prove that nurse practitioners and physician assistants in the intensive care unit may depend on lots of things, and care management is one of them.
Reference List
Kleinpell, R. & Grabenkort, R. (2008). Nurse Practitioners and Physician Assistants in the Intensive Care Unit: An Evidence-Based Review. Critical Care Medicine, 36 (10), 2888-2897.