PMID- 28461542
OWN - NLM
STAT- MEDLINE
DCOM- 20180716
LR  - 20180716
IS  - 1937-710X (Electronic)
IS  - 1062-3264 (Linking)
VI  - 26
IP  - 3
DP  - 2017 May
TI  - Nurses' Perceptions of In-Hospital Versus Telephone Availability of an
      Intensivist at Night in an Intensive Care Unit.
PG  - 203-209
LID - 10.4037/ajcc2017338 [doi]
AB  - BACKGROUND: Evidence suggests that in-person management by nighttime intensivists
      does not change patients' mortality rates in high-intensity intensive care units.
      OBJECTIVE: To better understand domains affected by nighttime intensivist
      staffing not previously measured. METHODS: Semistructured interviews of 13
      night-shift nurses in an academic medical intensive care unit to elicit
      perceptions of nighttime staffing with attending intensivists versus residents
      with attending intensivists on call remotely. Interviews were done during the
      final months of a randomized trial comparing the same staffing models.
      Qualitative analysis was done by using a grounded theory approach. Three
      investigators independently reviewed interview transcripts to identify key
      domains. RESULTS: In addition to 5 themes probed during interviews (efficiency,
      communication, job place comfort, quality of patient care, and procedures),
      participants identified 3 other themes (supervision, systems issues, and
      experience). Most participants thought that nighttime intensivists improved
      clinical care, procedures, efficiency, communication, and job place comfort. Two 
      thought that the quality of patient care, efficiency, or communication was the
      same with both arrangements. Three reported no effect on their job place comfort.
      Twelve mentioned improved supervision of trainees, and all thought systems issues
      improved. CONCLUSIONS: Nurses perceive improvements with nighttime intensivists
      in several domains. Future work is needed to determine whether such perceptions
      translate into improved outcomes for staff or patients.
CI  - (c)2017 American Association of Critical-Care Nurses.
FAU - Stanton, Emily S
AU  - Stanton ES
AD  - Emily S. Stanton was a pulmonary and critical care fellow at the Hospital of the 
      University of Pennsylvania, Philadelphia, Pennsylvania, and is now an attending
      physician at Kaiser Permanente, Lafayette, Colorado. Cary Hilbert was a research 
      coordinator at Perelman School of Medicine at the University of Pennsylvania, and
      is now an epidemiologist at the Centers for Disease Control and Prevention,
      Atlanta, Georgia. Stephanie Maillie is a clinical nurse specialist at the
      Hospital of the University of Pennsylvania. C. Jessica Dine is an assistant
      professor, Scott D. Halpern is an associate professor, and Meeta Prasad Kerlin is
      an assistant professor, Division of Pulmonary, Allergy, and Critical Care
      Medicine, Department of Medicine, Perelman School of Medicine at the University
      of Pennsylvania. Halpern is director and Kerlin is faculty at the Palliative and 
      Acute Illness Research (PAIR) Center; Halpern is director of the Fostering
      Improvement in End-of-Life Decision Science (FIELDS) Program; and Dine, Halpern, 
      and Kerlin are senior fellows of the Leonard Davis Institute of Health Economics 
      of the University of Pennsylvania.
FAU - Hilbert, Cary
AU  - Hilbert C
AD  - Emily S. Stanton was a pulmonary and critical care fellow at the Hospital of the 
      University of Pennsylvania, Philadelphia, Pennsylvania, and is now an attending
      physician at Kaiser Permanente, Lafayette, Colorado. Cary Hilbert was a research 
      coordinator at Perelman School of Medicine at the University of Pennsylvania, and
      is now an epidemiologist at the Centers for Disease Control and Prevention,
      Atlanta, Georgia. Stephanie Maillie is a clinical nurse specialist at the
      Hospital of the University of Pennsylvania. C. Jessica Dine is an assistant
      professor, Scott D. Halpern is an associate professor, and Meeta Prasad Kerlin is
      an assistant professor, Division of Pulmonary, Allergy, and Critical Care
      Medicine, Department of Medicine, Perelman School of Medicine at the University
      of Pennsylvania. Halpern is director and Kerlin is faculty at the Palliative and 
      Acute Illness Research (PAIR) Center; Halpern is director of the Fostering
      Improvement in End-of-Life Decision Science (FIELDS) Program; and Dine, Halpern, 
      and Kerlin are senior fellows of the Leonard Davis Institute of Health Economics 
      of the University of Pennsylvania.
FAU - Maillie, Stephanie
AU  - Maillie S
AD  - Emily S. Stanton was a pulmonary and critical care fellow at the Hospital of the 
      University of Pennsylvania, Philadelphia, Pennsylvania, and is now an attending
      physician at Kaiser Permanente, Lafayette, Colorado. Cary Hilbert was a research 
      coordinator at Perelman School of Medicine at the University of Pennsylvania, and
      is now an epidemiologist at the Centers for Disease Control and Prevention,
      Atlanta, Georgia. Stephanie Maillie is a clinical nurse specialist at the
      Hospital of the University of Pennsylvania. C. Jessica Dine is an assistant
      professor, Scott D. Halpern is an associate professor, and Meeta Prasad Kerlin is
      an assistant professor, Division of Pulmonary, Allergy, and Critical Care
      Medicine, Department of Medicine, Perelman School of Medicine at the University
      of Pennsylvania. Halpern is director and Kerlin is faculty at the Palliative and 
      Acute Illness Research (PAIR) Center; Halpern is director of the Fostering
      Improvement in End-of-Life Decision Science (FIELDS) Program; and Dine, Halpern, 
      and Kerlin are senior fellows of the Leonard Davis Institute of Health Economics 
      of the University of Pennsylvania.
FAU - Dine, C Jessica
AU  - Dine CJ
AD  - Emily S. Stanton was a pulmonary and critical care fellow at the Hospital of the 
      University of Pennsylvania, Philadelphia, Pennsylvania, and is now an attending
      physician at Kaiser Permanente, Lafayette, Colorado. Cary Hilbert was a research 
      coordinator at Perelman School of Medicine at the University of Pennsylvania, and
      is now an epidemiologist at the Centers for Disease Control and Prevention,
      Atlanta, Georgia. Stephanie Maillie is a clinical nurse specialist at the
      Hospital of the University of Pennsylvania. C. Jessica Dine is an assistant
      professor, Scott D. Halpern is an associate professor, and Meeta Prasad Kerlin is
      an assistant professor, Division of Pulmonary, Allergy, and Critical Care
      Medicine, Department of Medicine, Perelman School of Medicine at the University
      of Pennsylvania. Halpern is director and Kerlin is faculty at the Palliative and 
      Acute Illness Research (PAIR) Center; Halpern is director of the Fostering
      Improvement in End-of-Life Decision Science (FIELDS) Program; and Dine, Halpern, 
      and Kerlin are senior fellows of the Leonard Davis Institute of Health Economics 
      of the University of Pennsylvania.
FAU - Halpern, Scott D
AU  - Halpern SD
AD  - Emily S. Stanton was a pulmonary and critical care fellow at the Hospital of the 
      University of Pennsylvania, Philadelphia, Pennsylvania, and is now an attending
      physician at Kaiser Permanente, Lafayette, Colorado. Cary Hilbert was a research 
      coordinator at Perelman School of Medicine at the University of Pennsylvania, and
      is now an epidemiologist at the Centers for Disease Control and Prevention,
      Atlanta, Georgia. Stephanie Maillie is a clinical nurse specialist at the
      Hospital of the University of Pennsylvania. C. Jessica Dine is an assistant
      professor, Scott D. Halpern is an associate professor, and Meeta Prasad Kerlin is
      an assistant professor, Division of Pulmonary, Allergy, and Critical Care
      Medicine, Department of Medicine, Perelman School of Medicine at the University
      of Pennsylvania. Halpern is director and Kerlin is faculty at the Palliative and 
      Acute Illness Research (PAIR) Center; Halpern is director of the Fostering
      Improvement in End-of-Life Decision Science (FIELDS) Program; and Dine, Halpern, 
      and Kerlin are senior fellows of the Leonard Davis Institute of Health Economics 
      of the University of Pennsylvania.
FAU - Kerlin, Meeta Prasad
AU  - Kerlin MP
AD  - Emily S. Stanton was a pulmonary and critical care fellow at the Hospital of the 
      University of Pennsylvania, Philadelphia, Pennsylvania, and is now an attending
      physician at Kaiser Permanente, Lafayette, Colorado. Cary Hilbert was a research 
      coordinator at Perelman School of Medicine at the University of Pennsylvania, and
      is now an epidemiologist at the Centers for Disease Control and Prevention,
      Atlanta, Georgia. Stephanie Maillie is a clinical nurse specialist at the
      Hospital of the University of Pennsylvania. C. Jessica Dine is an assistant
      professor, Scott D. Halpern is an associate professor, and Meeta Prasad Kerlin is
      an assistant professor, Division of Pulmonary, Allergy, and Critical Care
      Medicine, Department of Medicine, Perelman School of Medicine at the University
      of Pennsylvania. Halpern is director and Kerlin is faculty at the Palliative and 
      Acute Illness Research (PAIR) Center; Halpern is director of the Fostering
      Improvement in End-of-Life Decision Science (FIELDS) Program; and Dine, Halpern, 
      and Kerlin are senior fellows of the Leonard Davis Institute of Health Economics 
      of the University of Pennsylvania. prasadm@uphs.upenn.edu.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Am J Crit Care
JT  - American journal of critical care : an official publication, American Association
      of Critical-Care Nurses
JID - 9211547
SB  - IM
SB  - N
MH  - Adult
MH  - *Attitude of Health Personnel
MH  - *Communication
MH  - Critical Care/*methods
MH  - Female
MH  - Humans
MH  - Intensive Care Units
MH  - Interviews as Topic
MH  - Male
MH  - Middle Aged
MH  - Nursing Staff, Hospital/*psychology
MH  - Pennsylvania
MH  - *Personnel Staffing and Scheduling
MH  - *Telephone
EDAT- 2017/05/04 06:00
MHDA- 2018/07/17 06:00
CRDT- 2017/05/03 06:00
PHST- 2017/05/03 06:00 [entrez]
PHST- 2017/05/04 06:00 [pubmed]
PHST- 2018/07/17 06:00 [medline]
AID - 26/3/203 [pii]
AID - 10.4037/ajcc2017338 [doi]
PST - ppublish
SO  - Am J Crit Care. 2017 May;26(3):203-209. doi: 10.4037/ajcc2017338.