Cardiovascular Rounds

The difference NPs made for ICU care in one hospital

by Kristen Barlow

Upon noticing suboptimal cost and quality performance for CV surgery patients, administrators at Loyola University Hospital in Illinois determined they needed to improve CV ICU patient management. To improve outcomes, administrators considered the possibility of leveraging NPs.

After assessing scope and practice among the individuals caring for CV ICU patients, administrators found that dedicated CV NPs could perform many of the same clinical duties as residents—and could do so with potentially better outcomes. As a result, new protocols were established to effectively transfer the majority of CV ICU clinical functions—including admission, case evaluation, and monitoring—to three dedicated CV NPs for the unit.

Delegating the bulk of patient management responsibilities from general surgery residents to specialized CV NPs generated impressive results for Loyola’s cardiac surgery program. Overall, administrators realized a 67% improvement in risk-adjusted CABG mortality over 3 years, and a 9% reduction in cost per case in the 12 months since implementation.

What is top-of-license nursing practice?

The idea of operating at the top of your license means practicing to the full extent of your education and training, instead of spending time doing something that could be effectively done by someone else.