Provider to patient ratios for nurse practitioners and physician assistants in critical care units.

BACKGROUND: Nurse practitioners and physician assistants are being increasingly integrated into intensive care unit and hospital-based care teams, yet limited information is available on provider to patient ratios.

OBJECTIVE: To determine current provider to patient ratios for nurse practitioners and physician assistants working in intensive and acute care units and to assess factors that affect the ratios.

METHODS: A descriptive study design was used with a Web-based survey of members of the American Association of Nurse Practitioners, American Academy of Physician Assistants, and the Society of Critical Care Medicine.

RESULTS: Responses were received from 222 nurse practitioners and 211 physician assistants from all but 8 of the 50 United States and from Canada. Mean provider to patient ratios in intensive care were 1 to 5 (range, 1 to 3 - 1 to 8). In pediatric intensive care, the mean ratio of nurse practitioners to patients was 1 to 4 (range, 1 to 3 - 1 to 8). Factors that affected nurse practitioner and physician assistant provider to patient ratios included patients' severity of illness, number of patients in the unit, number of providers in the unit, patient diagnosis, number of physicians in the unit, time of day, and number of fellows and medical residents on service.

CONCLUSIONS: Additional information on factors influencing provider to patient ratios and specific components of the roles of nurse practitioners and physician assistants will be important to ensure the best utilization of these providers to enable optimal patient care outcomes.