The experience of four outcomes managers: an institutional approach to weaning patients from long-term mechanical ventilation.
Care of patients requiring long-term mechanical ventilation (LTMV) is the focus of many hospitals nationwide. Because the care of patients who require LTMV is complex and morbidity and mortality are high, associated costs often exceed reimbursement. This article describes a successful institutional program for the care of the patient population requiring LTMV using advanced practice nurses (APNs) in the role of outcomes managers (OMs). So that others may benefit from the experiences of the clinicians, this article describes the historical background, the selection and qualifications of APNs, the process APNs use to manage and monitor the patients, role challenges, and associated outcomes.
Earven
Sidenia
S
University of Virginia Health System, Charlottesville, VA, USA.
Fisher
Charles
C
Lewis
Rose
R
Merrell
Paul
P
Burns
Suzanne M
SM
D019090:Case Management / Q000458:organization & administration; D002985:Clinical Protocols; D003422:Critical Care / Q000458:organization & administration*; D019091:Critical Pathways / Q000458:organization & administration*; D019317:Evidence-Based Medicine; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D016294:Models, Nursing; D008991:Monitoring, Physiologic / Q000451:nursing; D009017:Morbidity; D009722:Nurse Practitioners / Q000458:organization & administration*; D024802:Nurse's Role; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010043:Outcome and Process Assessment, Health Care / Q000458:organization & administration*; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D015300:Ventilator Weaning / Q000379:methods / Q000451:nursing* / Q000592:standards; D014768:Virginia / Q000453:epidemiology