• Fatmata Jalloh, Matthew D Tadlock, Stacy Cantwell, Timothy Rausch, Hande Aksoy, and Heidi Frankel.
• Fatmata Jalloh and Stacy Cantwell are nurse practitioners, Department of Surgery, and Heidi Frankel is medical director of the surgical intensive care unit, Keck Medical Center, University of Southern California, Los Angeles, California. Matthew D. Tadlock is a trauma fellow, and Hande Aksoy is a research fellow, Los Angeles County and University of Southern California Medical Center, Los Angeles, California. Timothy Rausch is a registered nurse, Ronald Reagan University of California, Los Angeles, Medical Center. fatmata_j@hotmail.com fjalloh@med.usc.edu.
• Am. J. Crit. Care. 2016 Jul 1; 25 (4): 357-61.

BackgroundAcute care nurse practitioners have been successfully integrated into inpatient settings. They perform invasive procedures in the intensive care unit and other acute care settings. Although their general scope of practice is regulated at the state level, local and regional scope of practice is governed by hospitals.ObjectiveTo determine if credentialing and privileging of these nurses for invasive procedures varies depending on the institution.MethodsPersonnel in medical staff offices of 329 hospitals were surveyed by telephone with 6 questions. Data collected included acute care nurse practitioner and hospital demographics, frequency and type of procedures performed, proctoring and credentialing process, and the presence of residents and fellows at the institution.ResultsThe response rate was 74.8% (246 hospitals). Among these, 48% (118) employed acute care nurse practitioners, of which 43.2% performed invasive procedures. Three hospitals were excluded from the final analysis. Of the hospitals that credentialed and granted privileges to the nurse practitioners for invasive procedures, 60.4% were teaching hospitals. A supervising physician was the proctor in 94% of the nonteaching hospitals and 100% of the teaching hospitals. The most common number of cases proctored was 4 to 7.ConclusionThe majority of hospitals employ acute care nurse practitioners. The most common method of privileging for invasive procedures is proctoring by a supervising physician. However, the amount of proctoring required before privileges and independent practice are granted varies by procedure and institution.©2016 American Association of Critical-Care Nurses.

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