title: Nurse practitioners in postoperative cardiac surgery: are they effective?
abstract: BACKGROUND
  High demand for acute care nurse practitioners (ACNPs) in Canadian postoperative cardiac surgery settings has outpaced methodologically rigorous research to support the role.
  
  
  OBJECTIVE
  To compare the effectiveness of ACNP-led care to hospitalist-led care in a postoperative cardiac surgery unit in a Canadian, university-affiliated, tertiary care hospital.
  
  
  METHODS
  Patients scheduled for urgent or elective coronary artery bypass and/or valvular surgery were randomly assigned to either ACNP-led (n=22) or hospitalist-led (n=81) postoperative care. Both ACNPs and hospitalists worked in collaboration with a cardiac surgeon. Outcome variables included length of hospital stay, hospital readmission rate, postoperative complications, adherence to follow-up appointments, attendance at cardiac rehabilitation and both patient and health care team satisfaction.
  
  
  RESULTS
  Baseline demographic characteristics were similar between groups except more patients in the ACNP-led group had had surgery on an urgent basis (p < or = 0.01), and had undergone more complicated surgical procedures (p < or =0.01). After discharge, more patients in the hospitalist-led group had visited their family doctor within a week (p < or =0.02) and measures of satisfaction relating to teaching, answering questions, listening and pain management were higher in the ACNP-led group.
  
  
  CONCLUSIONS
  Although challenges in recruitment yielded a lower than anticipated sample size, this study contributes to our knowledge of the ACNP role in postoperative cardiac surgery. Our findings provide support for the ACNP role in this setting as patients who received care from an ACNP had similar outcomes to hospitalist-led care and reported greater satisfaction in some measures of care.
authors.affiliation: School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC V6T 1Z3. Katie.Goldie@nursing.ubc.ca
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Goldie
authors.forename: Natasha
authors.initials: N
authors.lastname: Prodan-Bhalla
authors.forename: Martha
authors.initials: M
authors.lastname: Mackay
mesh_terms: D000368:Aged; D002170:Canada; D006348:Cardiac Surgical Procedures / Q000451:nursing*; D003266:Continuity of Patient Care; D005260:Female; D020445:Hospitalists; D006801:Humans; D008297:Male; D009722:Nurse Practitioners; D024802:Nurse's Role; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D011182:Postoperative Care / Q000451:nursing*; D011446:Prospective Studies; D016896:Treatment Outcome