Faculty of Nursing and Medical Care, Keio University, Kanagawa, Japan.
Division of Nursing, Higashigaoka Faculty of Nursing, Tokyo Healthcare University, Tokyo, Japan.
J Am Assoc Nurse Pract. 2024 Nov 1;36(11):629-636. doi: 10.1097/JXX.0000000000001046.
There are approximately 872 certified nurse practitioners (NPs) in Japan as of April 2024. However, research on the results of their specific activities is still scarce.
This study aimed to compare health care outcomes before (i.e., 2019) and after (i.e., 2021) employing NPs in cardiovascular hospitals in Japan.
We conducted a retrospective chart review and analyzed 114 patients who underwent cardiac surgery in Hospital A and 381 patients who received pacemaker implantation/replacement in Hospital B. Hospital A hired one NP for cardiac surgery service, and Hospital B hired one NP for pacemaker device service. The NPs assisted in the surgical procedures and provided postsurgical management.
In Hospital A, the median length of hospitalization and intubation were shorter in 2021 than in 2019 ( p = .02 and .01, respectively). In Hospital B, medical fee reimbursement was lower in 2021 ( p < .001) than in 2019, and the median procedure duration was shorter ( p = .01), which remained statistically significant after controlling for age, comorbidities, and device types. Some outcomes improved following the employment of NPs, whereas others remained unchanged.
Nurse practitioners managed surgical patients well and contributed to the quality care of cardiovascular medicine.
The employment of NPs in Japan is encouraged because even a single NP can have a positive, although not large, impact on patients and organizations.
截至 2024 年 4 月，日本约有 872 名认证护士从业者（NPs）。然而，关于他们具体活动结果的研究仍然很少。
本研究旨在比较日本心血管医院在雇用 NPs 前后（即 2019 年和 2021 年）的医疗保健结果。
我们进行了回顾性病历审查，并分析了在医院 A 接受心脏手术的 114 名患者和在医院 B 接受起搏器植入/更换的 381 名患者。医院 A 为心脏手术服务雇用了一名 NP，医院 B 为起搏器设备服务雇用了一名 NP。NPs 协助手术程序并提供术后管理。
在医院 A，2021 年患者的住院和插管中位时间均短于 2019 年（p =.02 和.01，分别）。在医院 B，2021 年的医疗费用报销低于 2019 年（p <.001），且手术持续时间中位数较短（p =.01），在控制年龄、合并症和设备类型后仍具有统计学意义。一些结果在雇用 NPs 后得到改善，而其他结果保持不变。
护士从业者很好地管理了手术患者，并为心血管医学的优质护理做出了贡献。
鼓励在日本雇用 NPs，因为即使只有一名 NPs，也可以对患者和组织产生积极的、虽然不是很大的影响。
