Physician extenders on surgical services: a systematic review
1From the Department of Orthopedic Surgery, University of Calgary, Calgary, Alta.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|March 23, 2017
Summary
Integrating nurse practitioners (NPs) and physician assistants (PAs) into surgical/trauma services improves patient care efficiency and resident well-being. This approach is safe, cost-effective, and addresses challenges from duty hour restrictions.
Area of Science:
- Medical Science
- Surgical Care
- Healthcare Management
Background:
- Resident duty hour restrictions create trainee shortages impacting patient care.
- Nurse practitioners (NPs) and physician assistants (PAs) offer a potential solution.
- Integration of NPs and PAs in surgical/trauma settings needs examination.
Purpose of the Study:
- To examine the impact of NPs and PAs on surgical/trauma services.
- To assess effects on patient outcomes and resident workload.
Main Methods:
- Systematic review of EMBASE, Medline, CINAHL, and Cochrane Central Register.
- Included studies on adult surgical/trauma services with NPs/PAs.
- Focused on outcomes like complications, length of stay, satisfaction, and workload.
Main Results:
- Addition of NPs/PAs decreased patient length of stay; morbidity/mortality remained unchanged.
- Resident workload decreased, sleep time increased, and operating time improved.
- High patient/healthcare worker satisfaction and reported cost savings.
Conclusions:
- NPs and PAs enhance surgical/trauma services safely and cost-effectively.
- This integration helps manage challenges from resident duty hour limits.
- Further research is needed to confirm findings and economic impact.
