Role of the Nurse Practitioner (NP) in Cardiovascular Surgery－Comparative Study of Surgical Assistants for NPs and Physicians－

Masato Saitoh＊	Takuma Yamasaki＊＊	Tomoaki Tanabe＊＊
Shuichi Tochigi＊＊	Shoh Tatebe＊＊	Yuki Ichimori＊＊
Imun Tei＊＊

(Department of Cardiovascular Surgery, Nurse Practitioner＊, and Department of Cardiovascular Surgery＊＊, Ayase Heart Hospital, Tokyo, Japan)

Background: Despite the recent increase in the number of institutions introducing nurse practitioners to perioperative management following cardiovascular surgery, limited reports have evaluated their performance. Objective: The current study aimed to evaluate nurse practitioners’ intervention based on perioperative outcomes following cardiovascular surgery. Methods: We performed a retrospective visualization of perioperative data following open-heart surgeries conducted at our hospital from April 1, 2019 to May 31, 2021, with the NP (99 patients) and DR (109 patients) groups consisting of patients whose first assistant was a nurse practitioner and physician, respectively. Results: No significant differences in patient characteristics were observed between the two groups. There were no significant differences in the operative time (304.4±92.7 vs. 301.4±86.8: min; p＝0.947), death within 30 days (n)(2 vs. 2; p＝0.923), and ICU stay (5.72±4.42 vs. 6.65±5.43: days; p＝0.302), between the two groups. No significant difference was observed in the occurrence of postoperative complications between the two groups. The NP group had significantly shorter hospital stay (18.6±6.7 vs. 23.0±9.8: days; p<0.001) and duration of ventilator management (19.7±22.6 vs. 28.8±50.2: h; p＝0.047) than the DR group. Discussion: The NP and DR groups exhibited comparable surgical outcomes. Perioperative management by a team including nurse practitioners, rather than by physicians alone, has been considered to reduce the duration of time spent on ventilator management and enable earlier hospital discharge, resulting in shorter hospital stays. This suggests that nurse practitioners, including surgical assistants under the direct supervision of physicians, may be able to safely perform perioperative management.

 

Jpn. J. Cardiovasc. Surg. 51: 339-344 （2022）

Keywords：nurse practitioners; cardiovascular surgery; physician assistant