• Ruth Kleinpell, Nicholas S Ward, Lynn A Kelso, Fred P Mollenkopf, and Douglas Houghton.
• Ruth Kleinpell is director, Center for Clinical Research and Scholarship, Rush University Medical Center; professor, Rush University College of Nursing; and acute care nurse practitioner, Rush Lincoln Park, Chicago, Illinois. Nicholas S. Ward is an intensivist at Rhode Island Hospital and an associate professor of medicine at Warren Alpert Medical School, Brown University, Providence, Rhode Island. Lynn A. Kelso is an assistant professor, University of Kentucky College of Nursing, and an acute care nurse practitioner, Department of Pulmonary, Critical Care, and Sleep Medicine, University of Kentucky, Lexington, Kentucky. Fred P. Mollenkopf, Jr is a physician assistant, Thoracic and Cardiovascular Institute, Lansing, Michigan. Douglas Houghton is an acute care nurse practitioner in the trauma intensive care unit, Jackson Health System, Miami Florida. ruth_m_kleinpell@rush.edu.
• Am. J. Crit. Care. 2015 May 1;24(3):e16-21.

BackgroundNurse practitioners and physician assistants are being increasingly integrated into intensive care unit and hospital-based care teams, yet limited information is available on provider to patient ratios.ObjectiveTo determine current provider to patient ratios for nurse practitioners and physician assistants working in intensive and acute care units and to assess factors that affect the ratios.MethodsA descriptive study design was used with a Web-based survey of members of the American Association of Nurse Practitioners, American Academy of Physician Assistants, and the Society of Critical Care Medicine.ResultsResponses were received from 222 nurse practitioners and 211 physician assistants from all but 8 of the 50 United States and from Canada. Mean provider to patient ratios in intensive care were 1 to 5 (range, 1 to 3 - 1 to 8). In pediatric intensive care, the mean ratio of nurse practitioners to patients was 1 to 4 (range, 1 to 3 - 1 to 8). Factors that affected nurse practitioner and physician assistant provider to patient ratios included patients' severity of illness, number of patients in the unit, number of providers in the unit, patient diagnosis, number of physicians in the unit, time of day, and number of fellows and medical residents on service.ConclusionsAdditional information on factors influencing provider to patient ratios and specific components of the roles of nurse practitioners and physician assistants will be important to ensure the best utilization of these providers to enable optimal patient care outcomes.©2015 American Association of Critical-Care Nurses.

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