Perceptions of Bedside Cardiac Critical Care Registered Nurses on 24 Hour Attending Intensivist Coverage.
OBJECTIVE
To elicit the perceptions of bedside critical care nurses toward continual in-house attending coverage and its effect on patient safety, communication, and nursing education.


METHODS
A 5-point Likert-type questionnaire was designed to evaluate the perception of bedside nurses in the pediatric cardiac intensive care unit (PCICU) toward the presence of a 24 hour in-house attending physician.


METHODS
Single tertiary referral PCICU in Washington, DC SUBJECTS: The 46 PCICU nurses who participated in the study were separated into two groups based on exposure to the recent implementation of continual in-house attending coverage at our institution. Group one consisted of 14 nurses with only exposure to the new 24/7 in-house coverage while group two encompassed 32 nurses who had experienced both the new and old system (off-site on-demand attending physician).


RESULTS
Surveys demonstrated that both groups found that the new system has a positive impact on nursing education (median score of 5) as well as a positive impact on the communication between multidisciplinary teams and between care team and families (median score of 5). Nurses who experienced only the new system scored one point lower (median score of 4) regarding the effect of this staffing model on patient outcomes than nurses who had experienced both systems (median score of 5, P = .016). Between 83% and 98% of all 46 nurses who participated indicated they agree or strongly agree with each of the questions regarding the benefit of 24 hour in-house attending coverage.


CONCLUSIONS
Our study suggests that regardless of differences in experience, pediatric cardiac nurses believe the presence of an on-site intensivist to be beneficial to both nursing and patients.
Departments of *Cardiothoracic Surgery and †Critical Care, Children's National Health System, Washington, DC, USA.
Fahad A
FA
Alfares
Department of Critical Care.
Melissa B
MB
Jones
Departments of *Cardiothoracic Surgery and †Critical Care, Children's National Health System, Washington, DC, USA.
Karthik
K
Ramakrishnan
Departments of *Cardiothoracic Surgery and †Critical Care, Children's National Health System, Washington, DC, USA.
Kendal M
KM
Endicott
Departments of *Cardiothoracic Surgery and †Critical Care, Children's National Health System, Washington, DC, USA.
David
D
Zurakowski
Department of Critical Care.
Venkat
V
Shankar
Departments of *Cardiothoracic Surgery and †Critical Care, Children's National Health System, Washington, DC, USA.
Dilip S
DS
Nath
D001291:Attitude of Health Personnel; D064646:Cardiovascular Nursing / Q000193:education; D003142:Communication; D064648:Critical Care Nursing / Q000193:education; D019033:Delivery of Health Care, Integrated; D004219:District of Columbia; D004506:Education, Nursing; D007722:Health Knowledge, Attitudes, Practice; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric; D008505:Medical Staff, Hospital; D000072222:Nurses, Pediatric / Q000193:education / Q000523:psychology*; D009741:Nursing Staff, Hospital / Q000193:education / Q000523:psychology*; D010348:Patient Care Team; D010465:Perception; D010561:Personnel Staffing and Scheduling; D011369:Professional-Patient Relations; D058996:Quality Improvement; D011787:Quality of Health Care; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers
Cardiac Pediatric Intensive Care Unit; Congenital Heart Disease; Nursing Perception; Organization And Administration; Physician Staffing Pattern; Survey