title: An impact evaluation of a newly developed pediatric cardiac intensive care unit.
abstract: OBJECTIVE
  The highly complex pediatric patients with congenital heart disease require interprofessional teamwork and collaboration to ensure high-quality outcomes with low mortality and morbidity (Congenit Heart Dis. 2013;8:3-19). The purpose of this study was to conduct an impact evaluation for a newly formed pediatric cardiac intensive care unit (PCICU) and to answer: Is there a difference between the pediatric intensive care unit and the PCICU on clinical outcome measures of pediatric cardiac postoperative patients and nursing resources?
  
  
  METHODS
  A retrospective pretest/posttest design was used with the independent variables being type of intensive care unit. The confounding variables included demographic data, clinical outcome data, registered nurse (RN) staffing data, and RN turnover data.
  
  
  METHODS
  The setting was a large, level I pediatric medical and surgical intensive care unit (ICU) located at a children's hospital within an academic medical center.
  
  
  METHODS
  The population was pediatric cardiac postoperative patients. Patients excluded were those older than 18 years or cases without a Society of Thoracic Surgeons and European Association for Cardiothoracic Surgery Congenital Heart Surgery Mortality Category score of 1 through 5.
  
  
  METHODS
  Owen's impact evaluation method and descriptive statistical measures, t test and Pearson χ test, were used for analysis.
  
  
  RESULTS
  Demographic data were comparable between the pediatric intensive care unit (n = 296) and PCICU (n = 333). No statistical differences were found in several of the clinical outcome measures. Statistically significant differences were found in surgeon (P = .00) and RN nursing hours per patient day for all cardiac patients (P = .01). The PCICU time frame had a higher RN turnover rate.
  
  
  CONCLUSIONS
  The majority of quality measures were not statistically different between the 2 ICUs. Even though statistical significance was not reached, the clinical impact of the PCICU's reduction in patient infections, mortality, and ICU length of stay was noted.
  
  
  CONCLUSIONS
  This evaluation has provided organizational leaders the quality indicators and costs that have been impacted with the addition of interprofessional teamwork and coordination of care through the development of a PCICU.
authors.affiliation: Author Affiliations: Chief Nursing and Clinical Services Officer (Dr Welander), Children's of Mississippi; Associate Professor of Nursing and Senior Director of Research and Evidence-Based Practice (Dr Keller) and Professor of Nursing and Director of Traditional Undergraduate Studies (Dr Northington), School of Nursing, University of Mississippi Medical Center, Jackson.
authors.forename: Michelle Hanna
authors.initials: MH
authors.lastname: Welander
authors.forename: Sheila D
authors.initials: SD
authors.lastname: Keller
authors.forename: LaDonna
authors.initials: L
authors.lastname: Northington
mesh_terms: D002648:Child; D003325:Coronary Care Units / Q000458:organization & administration*; D006330:Heart Defects, Congenital / Q000628:therapy*; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration*; D009726:Nurses / Q000706:statistics & numerical data; D010043:Outcome and Process Assessment, Health Care; D010561:Personnel Staffing and Scheduling / Q000706:statistics & numerical data; D010563:Personnel Turnover / Q000706:statistics & numerical data; D012189:Retrospective Studies