Carzoli R P, Martinez-Cruz M, Cuevas L L, Murphy S, Chiu T
Department of Pediatrics, University of Florida Health Science Center, Jacksonville.
Arch Pediatr Adolesc Med. 1994 Dec;148(12):1271-6. doi: 10.1001/archpedi.1994.02170120033005.
To compare patient care delivery by neonatal nurse practitioners and physician assistants with that of pediatric residents in the intensive care setting.
Retrospective chart review after developing specific performance criteria, namely, patient management, outcome, and charges.
METHODS/MATERIALS: Charts for 244 consecutive admissions to a neonatal intensive care unit in Jacksonville, Fla, were reviewed. Patients were cared for by one of two teams, one staffed by residents and the other by neonatal nurse practitioners and physician assistants. Similar patients were cared for by the two teams, as determined by patient background characteristics and diagnostic variables. Performance of the two teams was assessed by comparison of patient management, outcome, and charges. Management variables included data on length of critical care and hospital stay, ventilator and oxygen use, total parenteral nutritional use, number of transfusions, and the performance of various procedures. Outcome variables included the incidence of air leaks, bronchopulmonary dysplasia, intraventricular hemorrhage, patent ductus arteriosus, necrotizing enterocolitis, retinopathy of prematurity, and number of infants who died. Charge variables included hospital and physician charges.
Results demonstrated no significant differences in management, outcome, or charge variables between patients cared for by the two teams.
Neonatal nurse practitioners and physician assistants are an effective alternative to residents for patient care in the neonatal intensive care unit.
比较新生儿护理从业者和医师助理在重症监护环境中提供的患者护理与儿科住院医师提供的护理。
在制定特定绩效标准（即患者管理、结果和费用）后进行回顾性病历审查。
方法/材料：对佛罗里达州杰克逊维尔一家新生儿重症监护病房连续收治的244例患者的病历进行了审查。患者由两个团队之一护理，一个团队由住院医师组成，另一个团队由新生儿护理从业者和医师助理组成。根据患者背景特征和诊断变量确定，两个团队护理相似的患者。通过比较患者管理、结果和费用来评估两个团队的表现。管理变量包括重症监护和住院时间、呼吸机和氧气使用、全胃肠外营养使用、输血次数以及各种操作的执行情况等数据。结果变量包括气漏、支气管肺发育不良、脑室内出血、动脉导管未闭、坏死性小肠结肠炎、早产儿视网膜病变的发生率以及死亡婴儿数量。费用变量包括医院和医生费用。
结果表明，两个团队护理的患者在管理、结果或费用变量方面没有显著差异。
在新生儿重症监护病房，新生儿护理从业者和医师助理是替代住院医师进行患者护理的有效选择。
