THE CRITICAL CARE RESOURCE INTENSIVIST MODEL: AN ESSENTIAL COMPONENT TO CRITICAL CARE NURSING

Objectives: At a large academic level 1 trauma center, an additional resource was added on nights and weekends to optimize patient care, the Critical Care Resource Intensivist (CCRI), which is a multi-disciplinary group of fellowship-trained intensivists. Critical care nurses in the surgical, neurologic, medical and cardiac intensive care units (ICU) were anonymously surveyed to evaluate the CCRI model from a nursing perspective during three phases: prior to implementation, concurrent to implementation, and one-year post implementation.

Methods: An anonymous survey was sent to all nurses who worked nightshift in any of the critical care ICUs or rapid response teams . Survey results were aggregated via an electronic cloud-based survey tool. Our goal was to obtain qualitative data to inform hypothesis generation and quality improvement questions. As such, we collected free-text answers to the questions, “Do you ever have concerns about availability of faculty in the ICU?” and, “Do you have any suggestions or comments after implementation of CCRI?” Answers were categorized into pre- and post-CCRI strata.

Results: Two investigators (KR & MC) separately coded the data using a mixed deductive and inductive approach to the identification from the free-text answers of the responses by the critical care nurses. There were a few responses that fit into more than one theme due to the length of the response. Specific units, locations, and names of providers were taking out of free-text responds to provide anonymity. When coding the data, the two investigators (KR & MC) found a total of nine themes that connected all the free-text survey results from reimplementation, during implementation, and one-year post implementation of CCRI model. The themes [Figure/Table 1] included faculty accessibility, nurse safety, satisfaction, continuum of care and patient safety.

Conclusion: CCRI was uniformly and unanimously felt to improve patient care and decrease nursing stress as a result of the availability and responsiveness of critical care faculty on nights and weekends. The need to expand to the CCRI model across institutional campuses was also stated clearly within their responses. These surveys demonstrate the strong support for the CCRI model by critical care nurses. in a large academic level 1 trauma center. Further studies should investigate the effects of a CCRI model on nursing burnout and turnover rates.