Canadian Health&Care; Mall

Guidelines for the management of critically ill patients were determined by the affiliated university program. Consequently, no major changes in approaches to patient care were implemented during the study period. The following factors were evaluated: (a) number of monthly admissions, (b) occupancy, (c) APACHE II score as an index of intensity of disease, (d) duration of stay, (e) mortality, (f) number of invasive procedures, (g) number of complications, (h) utilization of laboratory resources, and (i) quality of charting. These factors were obtained on a monthly basis. Differences between the two periods were compared using the Wilcoxin rank sum nonparametric test with a p<0.05 considered statistically significant. Results As shown in Table 1, since the introduction of PAs into the medical ICU, there has been a slight reduction in the number of patients admitted and a slight increase in the duration of their stay. However, the occupancy rate, the mortality, the number of complications and the adequacy of charting remained unchanged. Although the utilization of laboratory studies was increased, the total number of studies requested remained within the acceptable averages for patients in an intensive care setting. Table 1—Vital Statistics

Factors	Residents	PAs
Admissions per month	37.0 ±5.7	30.4 ±8.9
Duration of stay (days)	3.96 ±0.92	4.62 ±1.91
Monthly mortality (%)	41.8 ±15.2	41.2 ±13.3
Monthly occupancy (%)	70.2 ±9.6	76.7 ±13.0
APACHE II score	15.2 ±6.5	16.3 ±7.2
Procedures per patient	2.1 ±0.2	2.8±0.9
Complications (2 yr)	6	5
Blood studies per patient	21.2 + 6.8	31.6 ±10.3
Cultures per patient	7.1 ±1.2	6.4±1.8
Incomplete charts (%)	0.22 ±0.01	0.18 ±0.02