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An Outcome Analysis of Nurse Practitioners in Acute Care Trauma Services

Holliday, Anna MSN, FNP-BC; Samanta, Damayanti MS; Budinger, Julie MSN, ACNP-BC, GNP-BC; Hardway, Jessica DNP, NP-C; Bethea, Audis PharmD, BCPS

doi: 10.1097/JTN.0000000000000327
RESEARCH
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The department of trauma at a Level 1 trauma center sought to improve outcomes by enhancing the continuity of care for patients admitted to trauma services. Departmental leadership explored opportunities to improve this aspect of patient care through expansion of existing trauma nurse practitioner (NP) services. The restructured trauma NP service model was implemented in September 2013. A retrospective study was conducted with patients who presented at the trauma center between September 2012 and August 2015. Patients with at least a 24-hr hospital length of stay (LOS) were separated into 3 comparator groups by 12-month increments: 12 months pre-, 12 months during, and 12 months postimplementation. Data revealed improvement in hospital LOS, intensive care unit LOS, time to place rehabilitation consultation, and placement of discharge orders before noon. A significant decline in the rate of complications including pneumonia and deep vein thrombosis (DVT) was also noted. Accordingly, expansion of the trauma NP model resulted in significant improvements in patient and process of care outcomes. This model for NP services may prove to be beneficial for acute care settings at other hospitals with high volume trauma services.

Center for Health Services and Outcomes Research, Charleston Area Medical Center, Charleston, West Virginia (Ms Samanta and Dr Bethea); Charleston Area Medical Center, Charleston, West Virginia (Mss Holliday, Budinger, and Hardway).

Correspondence: Audis Bethea, PharmD, BCPS, Center for Health Services and Outcomes Research, Charleston Area Medical Center, 3211 MacCorkle Ave, SE, Charleston, WV 25304 (audis.bethea@camc.org).

Research reported in this publication was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number U54GM104942. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Anna Holliday conceived the study, provided critical revision of the manuscript and approved the final version of the manuscript. Damayanti Samanta contributed to data review and analysis, writing and revision of this manuscript, and approved the final version of the manuscript. Julie Budinger was involved in writing of the manuscript, provided critical revision of the manuscript, and approved the final version of the manuscript. Jessica Hardway was involved in writing of the manuscript, provided critical revision of the manuscript, and approved the final version of the manuscript. Audis Bethea, PharmD, BCPS, provided oversight for all processes pertaining to the current study including design, data analysis, writing, and critical revision of the manuscript, and approved the final version of the manuscript.

Anna Holliday, Julie Budinger, and Jessica Hardway have no financial disclosures.

Damayanti Samanta is a member and Audis Bethea is a research scientist for the West Virginia Clinical Translational Science Institute.

The authors declare no conflicts of interest.

Copyright © 2017 by the Society of Trauma Nurses.