Differences in Care Provided in Intensive Care Units (ICUs) With Physician Versus Nurse Practitioner First Responders

NCT ID: NCT01323816

Last Updated: 2014-06-27

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

3659 participants

Study Classification

OBSERVATIONAL

Study Start Date

2011-03-31

Study Completion Date

2014-05-31

Brief Summary

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The purpose of this study is to evaluate and compare outcomes of patients that have received care in medical intensive care units in a tertiary care facility with two different models; the traditional model including resident, pulmonary fellow and attending physician and a nontraditional model which has Nurse Practitioners as the direct care deliverer, a pulmonary fellow, and an attending.

Detailed Description

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This will be a retrospective cohort study that is performed between two medical intensive care units (ICU). The goal is to compare outcomes of patients that have received care in medical intensive care units in a tertiary care facility with two different models; the traditional model including a resident, pulmonary fellow and attending and a nontraditional model which has Nurse Practitioners as the direct care deliverer, a pulmonary fellow, and an attending. Outcomes that will be measured include ICU length of stay, hospital length of stay after ICU discharge, ventilator days, daily spontaneous breathing trials, and daily awakening trials, as well as mortality in hospital and after discharge.

Conditions

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Critical Illness

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Traditional

ICU staffed by a resident, pulmonary fellow and attending

Medically directed care

Intervention Type OTHER

There is no research directed care. Patients are treated as medically indicated.

Non-Traditional

ICU staffed by Nurse Practitioners as the direct care deliverer, a pulmonary fellow, and an attending

Medically directed care

Intervention Type OTHER

There is no research directed care. Patients are treated as medically indicated.

Interventions

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Medically directed care

There is no research directed care. Patients are treated as medically indicated.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients admitted to designated ICU between September 1, 2007 and September 30, 2010.

Exclusion Criteria

* Not admitted to designated ICU.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Naeem Ali, MD

OTHER

Sponsor Role lead

Responsible Party

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Naeem Ali, MD

Medical Director, Medical Intensive Care Unit (MICU);

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Naeem Ali, M.D.

Role: PRINCIPAL_INVESTIGATOR

Ohio State University

Locations

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The Ohio State University

Columbus, Ohio, United States

Site Status

Countries

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United States

References

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Cooper LM, Linde-Zwirble WT. Medicare intensive care unit use: analysis of incidence, cost, and payment. Crit Care Med. 2004 Nov;32(11):2247-53. doi: 10.1097/01.ccm.0000146301.47334.bd.

Reference Type BACKGROUND
PMID: 15640637 (View on PubMed)

Halpern NA, Pastores SM, Greenstein RJ. Critical care medicine in the United States 1985-2000: an analysis of bed numbers, use, and costs. Crit Care Med. 2004 Jun;32(6):1254-9. doi: 10.1097/01.ccm.0000128577.31689.4c.

Reference Type BACKGROUND
PMID: 15187502 (View on PubMed)

Kleinpell RM, Ely EW, Grabenkort R. Nurse practitioners and physician assistants in the intensive care unit: an evidence-based review. Crit Care Med. 2008 Oct;36(10):2888-97. doi: 10.1097/CCM.0b013e318186ba8c.

Reference Type BACKGROUND
PMID: 18766097 (View on PubMed)

Mitchell-DiCenso A, Guyatt G, Marrin M, Goeree R, Willan A, Southwell D, Hewson S, Paes B, Rosenbaum P, Hunsberger M, Baumann A. A controlled trial of nurse practitioners in neonatal intensive care. Pediatrics. 1996 Dec;98(6 Pt 1):1143-8.

Reference Type BACKGROUND
PMID: 8951267 (View on PubMed)

Pronovost PJ, Angus DC, Dorman T, Robinson KA, Dremsizov TT, Young TL. Physician staffing patterns and clinical outcomes in critically ill patients: a systematic review. JAMA. 2002 Nov 6;288(17):2151-62. doi: 10.1001/jama.288.17.2151.

Reference Type BACKGROUND
PMID: 12413375 (View on PubMed)

Treggiari MM, Martin DP, Yanez ND, Caldwell E, Hudson LD, Rubenfeld GD. Effect of intensive care unit organizational model and structure on outcomes in patients with acute lung injury. Am J Respir Crit Care Med. 2007 Oct 1;176(7):685-90. doi: 10.1164/rccm.200701-165OC. Epub 2007 Jun 7.

Reference Type BACKGROUND
PMID: 17556721 (View on PubMed)

Other Identifiers

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2009H0145

Identifier Type: -

Identifier Source: org_study_id

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