A role in trauma care for advanced practice clinicians

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Advanced practice clinicians (APCs) are increasingly being utilized to care for patients on trauma services, but the quality of care provided by these alternate delivery models has been questioned. We hypothesized that APCs could safely administer trauma care that had traditionally been provided by surgical residents. Outcomes from an APC trauma-care delivery model were compared with those reported in the National Trauma Data Bank (NTDB). Parameters included in the comparison were mechanism of injury (MOI), length of hospital stay (LOS), injury severity score (ISS), and mortality. When MOI was used as the basis of comparison, the percentage of patients treated at the trauma center and the percentage of patients with information in the NTDB were similar. Despite having more seriously injured patients, the APC-staffed trauma center demonstrated a shorter LOS for all ISS categories; comparisons of patients with ISS >24 did not reach statistical significance. In addition, the APC-staffed trauma center had a statistically lower overall combined mortality rate when categorized by ISS. We conclude that an APC trauma-care delivery model provides outcomes at least as good as those reported by the NTDB.

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