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Updated: Jun 18, 2025
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
Published on: May 26, 2023
Nurse Practitioner and Physician Assistant-led Cardiovascular Surgery Postoperative Intensive Care Unit Staffing
Ralph T Perry1, John W Weimer1, Carrie Pratt1
1Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA.
Objectives:
To determine whether a nurse practitioner and physician assistant (NP/PA)-led rapid staffing. Model in the cardiac surgical intensive care unit (ICU) can optimize resource utilization without compromising safety or increasing hospital length of stay (LoS).
Design:
Retrospective observational cohort study comparing before-and-after implementation of an NP/PA-led rapid recovery pathway.
Setting:
A large tertiary referral academic cardiac surgery ICU.
Participants:
There were 116 patients in the prerapid recovery cohort and 153 in the postimplementation rapid recovery phase.
Interventions:
Low-risk cardiac surgery patients were selected for postoperative care by an NP/PA-led ICU staffing model.
Measurements And Main Results:
Mean hospital LoS in the prerapid recovery cohort was 5.7 days compared to 5.2 days in the rapid recovery pathway cohort (P = .02). Thirty-day hospital readmission in the prerapid recovery pathway cohort was 7.8% compared with 2.0% in the rapid recovery cohort (P = .04). The ICU readmission rate for prerapid recovery cohort was 4.3%, while the rapid recovery percentage was 2.0% (P = .30).
Conclusions:
Overall, implementation of an NP/PA-led postcardiac surgical ICU team (rapid recovery pathway) was associated with similar ICU LoS, hospital LoS, ICU readmission rates, 30-day readmission rates, and no significant signal of increased adverse events or safety concerns.
