Acute Care Nurse Practitioners in an Academic Multidisciplinary ICU

The need for acute care nurse practitioners (ACNPs) in the intensive care unit (ICU) has steadily increased over the years. This is in part because of an increase in hospital admissions from an aging population that is living longer from advances in health care, especially in the critical care arena. Another factor involves recommendations by the Leapfrog Group that include fundamental critical care support be readily available to the patient’s bedside within 5 minutes. However, the largest driving force is the human resources shortage in critical care medicine. More and more patients are requiring critical care services, whereas physician numbers are not keeping pace with the growth. In addition, duty hour restrictions implemented by the Accreditation Council for Graduate Medical Education that limits residents’ work hours is contributing to the shortage. As a medium-to-large public tertiary academic medical center that serves all of northern California and part of the Central Valley, we have not been spared from the increase in workload in addition to the decrease in house staff support. The purpose of this article is to describe our experience with the use and integration of ACNPs into our multidisciplinary ICU teams.