SCCM Resource Library-APPs in the Critical Care Workforce: Past, Present, and Future

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The utilization of Advanced Practice Providers (APPs) such as nurse practitioners (NPs), physician assistants (PAs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs) has been steadily growing in critical care, especially amid the COVID-19 pandemic, which intensified the demand for skilled healthcare providers. APPs are integral in providing 24/7 complex care in intensive care units, contributing significantly to multiprofessional healthcare teams.<br /><br />In the U.S., there are approximately 300,000 licensed NPs, with 41.7% holding hospital privileges, and over 150,000 PAs, with 37% working in hospital settings. APPs are nationally certified, state-licensed, and function as interdisciplinary consultants, patient advocates, educators, and researchers. Studies highlight that APPs can outperform traditional physicians in teamwork, protocol adherence, communication, and patient satisfaction.<br /><br />Due to the pandemic, many states temporarily expanded APPs' practice authority, waiving supervisory requirements, thus allowing them full practice capabilities independent of physician oversight. This shift demonstrated the high quality and cost-effectiveness of APPs, a factor hospitals might continue leveraging post-pandemic for financial efficiency and improved healthcare outcomes.<br /><br />Legislation, like Florida's March 2020 law, is expanding APPs' scopes, potentially revising NP and PA education models to accommodate specialty needs. With aging baby boomers and a predicted physician shortage, APPs are seen as crucial resources to relieve critical care staffing pressures and ensure continuity of care across settings—from ICUs to long-term acute care facilities.<br /><br />Future development in APP roles involves collaboration with physicians, adapting education paths, and navigating legislative changes to enhance healthcare delivery while ensuring high standards of patient care. This ongoing evolution underscores the significant role APPs play in modern healthcare, both independently and in partnership with other medical professionals.

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Administration, Professional Development and Education, 2021, 00:05:25

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This article was first published in the Spring 2021 issue of Critical Connections.

The utilization of advanced practice providers (APP) in the workforce has continued to grow, particularly over the past year, during which hospitals saw unprecedented surges of critically ill patients. Although it would be simple to focus just on the role of the APP at the bedside, the term encompasses a variety of clinicians, including:

Nurse practitioners (NPs), trained as family NPs, acute care NPs, or adult gerontology acute care NPs
Physician assistants (PAs)
Clinical nurse specialists (CNSs)
Certified registered nurse anesthetists (CRNAs)

Critical Connections, the critical care industry's only newsmagazine, provides information on cutting-edge topics in critical care useful to the entire multiprofessional team.Diane McLaughlin, DNP-AGACNP-BC, CCRN
Shannon Burns, DNP, AGACNP-BC
Kimberly Ichrist, DNP, AGACNP-BC, CCRN

Meta Tag

Content Type Article

Knowledge Area Administration

Knowledge Area Professional Development and Education

Knowledge Level Foundational

Knowledge Level Intermediate

Knowledge Level Advanced

Membership Level Select

Membership Level Professional

Membership Level Associate

Tag Staffing

Tag APP Administration

Year 2021

Keywords

Advanced Practice Providers

nurse practitioners

physician assistants

critical care

COVID-19 pandemic

healthcare teams

practice authority

legislation

patient care

healthcare delivery

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