{"title":"日本心血管病医院聘用执业护士前后的医疗效果比较：回顾性病历","authors":"Miho Suzuki, Natsuko Sekiguchi, Masato Saitoh, Masahide Koda, Nahoko Harada, Kazuya Honda, Tomoko Araki, Takemi Kudo, Takako Watanabe","doi":"10.1097/JXX.0000000000001046","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>There are approximately 872 certified nurse practitioners (NPs) in Japan as of April 2024. However, research on the results of their specific activities is still scarce.</p><p><strong>Purpose: </strong>This study aimed to compare health care outcomes before (i.e., 2019) and after (i.e., 2021) employing NPs in cardiovascular hospitals in Japan.</p><p><strong>Methodology: </strong>We conducted a retrospective chart review and analyzed 114 patients who underwent cardiac surgery in Hospital A and 381 patients who received pacemaker implantation/replacement in Hospital B. Hospital A hired one NP for cardiac surgery service, and Hospital B hired one NP for pacemaker device service. The NPs assisted in the surgical procedures and provided postsurgical management.</p><p><strong>Results: </strong>In Hospital A, the median length of hospitalization and intubation were shorter in 2021 than in 2019 ( p = .02 and .01, respectively). In Hospital B, medical fee reimbursement was lower in 2021 ( p < .001) than in 2019, and the median procedure duration was shorter ( p = .01), which remained statistically significant after controlling for age, comorbidities, and device types. Some outcomes improved following the employment of NPs, whereas others remained unchanged.</p><p><strong>Conclusions: </strong>Nurse practitioners managed surgical patients well and contributed to the quality care of cardiovascular medicine.</p><p><strong>Implications: </strong>The employment of NPs in Japan is encouraged because even a single NP can have a positive, although not large, impact on patients and organizations.</p>","PeriodicalId":17179,"journal":{"name":"Journal of the American Association of Nurse Practitioners","volume":" ","pages":"629-636"},"PeriodicalIF":1.2000,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556880/pdf/","citationCount":"0","resultStr":"{\"title\":\"Comparing health care outcomes before and after employing nurse practitioners in cardiovascular hospitals in Japan: A retrospective chart review.\",\"authors\":\"Miho Suzuki, Natsuko Sekiguchi, Masato Saitoh, Masahide Koda, Nahoko Harada, Kazuya Honda, Tomoko Araki, Takemi Kudo, Takako Watanabe\",\"doi\":\"10.1097/JXX.0000000000001046\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>There are approximately 872 certified nurse practitioners (NPs) in Japan as of April 2024. However, research on the results of their specific activities is still scarce.</p><p><strong>Purpose: </strong>This study aimed to compare health care outcomes before (i.e., 2019) and after (i.e., 2021) employing NPs in cardiovascular hospitals in Japan.</p><p><strong>Methodology: </strong>We conducted a retrospective chart review and analyzed 114 patients who underwent cardiac surgery in Hospital A and 381 patients who received pacemaker implantation/replacement in Hospital B. Hospital A hired one NP for cardiac surgery service, and Hospital B hired one NP for pacemaker device service. The NPs assisted in the surgical procedures and provided postsurgical management.</p><p><strong>Results: </strong>In Hospital A, the median length of hospitalization and intubation were shorter in 2021 than in 2019 ( p = .02 and .01, respectively). In Hospital B, medical fee reimbursement was lower in 2021 ( p < .001) than in 2019, and the median procedure duration was shorter ( p = .01), which remained statistically significant after controlling for age, comorbidities, and device types. Some outcomes improved following the employment of NPs, whereas others remained unchanged.</p><p><strong>Conclusions: </strong>Nurse practitioners managed surgical patients well and contributed to the quality care of cardiovascular medicine.</p><p><strong>Implications: </strong>The employment of NPs in Japan is encouraged because even a single NP can have a positive, although not large, impact on patients and organizations.</p>\",\"PeriodicalId\":17179,\"journal\":{\"name\":\"Journal of the American Association of Nurse Practitioners\",\"volume\":\" \",\"pages\":\"629-636\"},\"PeriodicalIF\":1.2000,\"publicationDate\":\"2024-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11556880/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Association of Nurse Practitioners\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/JXX.0000000000001046\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Association of Nurse Practitioners","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/JXX.0000000000001046","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
摘要
背景：截至 2024 年 4 月，日本约有 872 名注册执业护士（NPs）。目的：本研究旨在比较日本心血管医院聘用 NPs 之前（即 2019 年）和之后（即 2021 年）的医疗结果：我们对在 A 医院接受心脏手术的 114 名患者和在 B 医院接受起搏器植入/更换手术的 381 名患者进行了回顾性病历审查和分析。护士协助手术过程并提供术后管理：在 A 医院，2021 年的中位住院时间和插管时间比 2019 年短（p = .02 和 .01）。在 B 医院，2021 年的医疗费用报销额度低于 2019 年（p < .001），中位手术持续时间更短（p = .01），在控制了年龄、合并症和设备类型后，仍具有统计学意义。聘用护士后，一些结果得到改善，而另一些结果则保持不变：结论：护士对手术患者的管理良好，为心血管内科的优质护理做出了贡献：日本鼓励聘用护士，因为即使是一名护士也能对患者和机构产生积极的影响，尽管这种影响并不大。
Comparing health care outcomes before and after employing nurse practitioners in cardiovascular hospitals in Japan: A retrospective chart review.
Background: There are approximately 872 certified nurse practitioners (NPs) in Japan as of April 2024. However, research on the results of their specific activities is still scarce.
Purpose: This study aimed to compare health care outcomes before (i.e., 2019) and after (i.e., 2021) employing NPs in cardiovascular hospitals in Japan.
Methodology: We conducted a retrospective chart review and analyzed 114 patients who underwent cardiac surgery in Hospital A and 381 patients who received pacemaker implantation/replacement in Hospital B. Hospital A hired one NP for cardiac surgery service, and Hospital B hired one NP for pacemaker device service. The NPs assisted in the surgical procedures and provided postsurgical management.
Results: In Hospital A, the median length of hospitalization and intubation were shorter in 2021 than in 2019 ( p = .02 and .01, respectively). In Hospital B, medical fee reimbursement was lower in 2021 ( p < .001) than in 2019, and the median procedure duration was shorter ( p = .01), which remained statistically significant after controlling for age, comorbidities, and device types. Some outcomes improved following the employment of NPs, whereas others remained unchanged.
Conclusions: Nurse practitioners managed surgical patients well and contributed to the quality care of cardiovascular medicine.
Implications: The employment of NPs in Japan is encouraged because even a single NP can have a positive, although not large, impact on patients and organizations.
期刊介绍：
The Journal of the American Association of Nurse Practitioners (JAANP) is a monthly peer-reviewed professional journal that serves as the official publication of the American Association of Nurse Practitioners.
Published since 1989, the JAANP provides a strong clinical focus with articles related to primary, secondary, and tertiary care, nurse practitioner education, health policy, ethics and ethical issues, and health care delivery. The journal publishes original research, integrative/comprehensive reviews, case studies, a variety of topics in clinical practice, and theory-based articles related to patient and professional education. Although the majority of nurse practitioners function in primary care, there is an increasing focus on the provision of care across all types of systems from acute to long-term care settings.
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