Background: Determining the conditions that promote high performing advanced nursing practice is important because hospitals are increasingly dependent on the use of nurse practitioners (NPs) to deliver front-line care to acute and critically ill patients.
Objective: To describe the outcomes of a front-line care model that uses certified pediatric acute care NPs, limits work hours and night time and weekend patient-to-provider ratio, on the outcomes of patients cared for in an academic Pediatric Intensive Care Unit (PICU).
Methods: A retrospective quasi-experimental design was used to describe the outcomes of an NP Team model compared to a physician-only, Traditional Medical Team model that existed simultaneously in the same PICU.
Results: Patients cared for by the NP Team had lower mean acuity, experienced equivalent mortality, shorter length of stay (LOS), and with the exception of Catheter Related Urinary Tract Infections (CAUTI), slightly lower device associated hospital acquire infection rates compared to those cared for by a Traditional Medical Team.
Conclusions: In an academic PICU, a front-line care delivery model that used certified pediatric acute care NPs who were intermittently supplemented by pediatric hospitalist pediatricians and residents, and that limits work hours and night time and weekend patient-to-provider ratio, resulted in outcomes that are at least equivalent to those of traditional medical teams.
","abstract_html":"<p>Background: Determining the conditions that promote high performing advanced nursing practice is important because hospitals are increasingly dependent on the use of nurse practitioners (NPs) to deliver front-line care to acute and critically ill patients.</p> <p>Objective: To describe the outcomes of a front-line care model that uses certified pediatric acute care NPs, limits work hours and night time and weekend patient-to-provider ratio, on the outcomes of patients cared for in an academic Pediatric Intensive Care Unit (PICU).</p> <p>Methods: A retrospective quasi-experimental design was used to describe the outcomes of an NP Team model compared to a physician-only, Traditional Medical Team model that existed simultaneously in the same PICU.</p> <p>Results: Patients cared for by the NP Team had lower mean acuity, experienced equivalent mortality, shorter length of stay (LOS), and with the exception of Catheter Related Urinary Tract Infections (CAUTI), slightly lower device associated hospital acquire infection rates compared to those cared for by a Traditional Medical Team.</p> <p>Conclusions: In an academic PICU, a front-line care delivery model that used certified pediatric acute care NPs who were intermittently supplemented by pediatric hospitalist pediatricians and residents, and that limits work hours and night time and weekend patient-to-provider ratio, resulted in outcomes that are at least equivalent to those of traditional medical teams.</p>","abstract_has_math":false,"creators":["Trimarchi, Tara"],"institution":null,"degree_name":"Doctor of Nursing Practice (DNP)","degree_level":"Open Access Thesis","degree_discipline":"Yale University School of Nursing","degree_department":null,"school":null,"contributors":["Margaret Grey"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2017,"date_issued":"2017-01-01T08:00:00Z","date_published":"2017-01-01T08:00:00Z","updated_at":"2026-07-24T06:16:00Z","subjects":["Care Model","Nurse Practitioner","Pediatric Intensive Care Unit"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://elischolar.library.yale.edu/ysndt/1079","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Margaret Grey"]},{"key":"dc:creator","label":"Author","values":["Trimarchi, Tara"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"thesis:degree_discipline","label":"Discipline","values":["Yale University School of Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Open Access Thesis"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Nursing Practice (DNP)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Care Model","Nurse Practitioner","Pediatric Intensive Care Unit"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://elischolar.library.yale.edu/ysndt/1079"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: Determining the conditions that promote high performing advanced nursing practice is important because hospitals are increasingly dependent on the use of nurse practitioners (NPs) to deliver front-line care to acute and critically ill patients.
Objective: To describe the outcomes of a front-line care model that uses certified pediatric acute care NPs, limits work hours and night time and weekend patient-to-provider ratio, on the outcomes of patients cared for in an academic Pediatric Intensive Care Unit (PICU).
Methods: A retrospective quasi-experimental design was used to describe the outcomes of an NP Team model compared to a physician-only, Traditional Medical Team model that existed simultaneously in the same PICU.
Results: Patients cared for by the NP Team had lower mean acuity, experienced equivalent mortality, shorter length of stay (LOS), and with the exception of Catheter Related Urinary Tract Infections (CAUTI), slightly lower device associated hospital acquire infection rates compared to those cared for by a Traditional Medical Team.
Conclusions: In an academic PICU, a front-line care delivery model that used certified pediatric acute care NPs who were intermittently supplemented by pediatric hospitalist pediatricians and residents, and that limits work hours and night time and weekend patient-to-provider ratio, resulted in outcomes that are at least equivalent to those of traditional medical teams.
"]},{"key":"dc:title","label":"Title","values":["Outcomes Of A Pediatric Acute Care Nurse Practitioner Driven Front-Line Care Delivery Model In An Academic Pediatric Intensive Care Unit"]}]}],"canonical_facts":{"dc:contributor":["Margaret Grey"],"dc:creator":["Trimarchi, Tara"],"dc:description.abstract":["Background: Determining the conditions that promote high performing advanced nursing practice is important because hospitals are increasingly dependent on the use of nurse practitioners (NPs) to deliver front-line care to acute and critically ill patients.
Objective: To describe the outcomes of a front-line care model that uses certified pediatric acute care NPs, limits work hours and night time and weekend patient-to-provider ratio, on the outcomes of patients cared for in an academic Pediatric Intensive Care Unit (PICU).
Methods: A retrospective quasi-experimental design was used to describe the outcomes of an NP Team model compared to a physician-only, Traditional Medical Team model that existed simultaneously in the same PICU.
Results: Patients cared for by the NP Team had lower mean acuity, experienced equivalent mortality, shorter length of stay (LOS), and with the exception of Catheter Related Urinary Tract Infections (CAUTI), slightly lower device associated hospital acquire infection rates compared to those cared for by a Traditional Medical Team.
Conclusions: In an academic PICU, a front-line care delivery model that used certified pediatric acute care NPs who were intermittently supplemented by pediatric hospitalist pediatricians and residents, and that limits work hours and night time and weekend patient-to-provider ratio, resulted in outcomes that are at least equivalent to those of traditional medical teams.
"],"dc:identifier":["https://elischolar.library.yale.edu/ysndt/1079"],"dc:subject":["Care Model","Nurse Practitioner","Pediatric Intensive Care Unit"],"dc:title":["Outcomes Of A Pediatric Acute Care Nurse Practitioner Driven Front-Line Care Delivery Model In An Academic Pediatric Intensive Care Unit"],"thesis:degree_discipline":["Yale University School of Nursing"],"thesis:degree_level":["Open Access Thesis"],"thesis:degree_name":["Doctor of Nursing Practice (DNP)"]},"updated_at":"2026-07-24T06:16:00Z"}