• Tracie White, Justin Kokiousis, Stephanie Ensminger, and Maria Shirey.
• Tracie White is Adult Care Nurse Practitioner, University of Alabama at Birmingham, 1720 2nd Ave South, Birmingham, AL 35294 (twhite220@uab.edu). Justin Kokiousis is Family Nurse Practitioner, University of Alabama, Birmingham, Alabama. Stephanie Ensminger is Adult-Gerontology Acute Care Nurse Practitioner, University of Alabama, Birmingham, Alabama. Maria Shirey is Professor and Chair, Acute, Chronic, and Continuing Care, University of Alabama at Birmingham, School of Nursing, Birmingham, Alabama.
• AACN Adv Crit Care. 2017 Jan 1; 28 (2): 111-123.

AbstractIn the United States, providing health care to critically ill patients is a challenge. An increase in patients older than 65 years, a decrease in critical care physicians, and a decrease in work hours for residents cause intensivist staffing issues. In this article, use of nurse practictioners to fill the intensive care unit intensivist staffing gap is assessed and evidence-based recommendations are identified to better incorporate nurse practitioners as part of intensive care unit intensivist staffing. The literature reveals that when nurse practitioners are part of a staffing model, outcomes are either positively impacted or no different from physician outcomes. However, successfully integrating nurse practitioners into an intensive care unit team is not adequately discussed in the literature. This gap is addressed and 3 mechanisms to integrate nurse practitioners into the intensive care unit are identified: (1) use of a multidisciplinary staffing model, (2) completion of onboarding programs, and (3) evaluation of nurse practitioner productivity.©2017 American Association of Critical-Care Nurses.

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