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. 2024 Apr 4;11(4):ofae141.
doi: 10.1093/ofid/ofae141. eCollection 2024 Apr.

Teams in Transition: Increasing Role of Advanced Practice Providers in Antimicrobial Use and Infectious Diseases Consultation

Reinaldo Perez  1   2 , Michael E Yarrington  1   2 , Connor R Deri  3 , Michael J Smith  2   4 , Jillian Hayes  3 , Rebekah H Wrenn  3 , Rebekah W Moehring  1   2
Affiliations

Teams in Transition: Increasing Role of Advanced Practice Providers in Antimicrobial Use and Infectious Diseases Consultation

Reinaldo Perez et al. Open Forum Infect Dis. .

Abstract

Background: Advanced practice providers (APPs) have taken on increasing responsibilities as primary team members in acute care hospitals, but the impact of this practice shift on antimicrobial prescribing and infectious diseases (ID) consultation requests is unknown. Here we describe longitudinal trends in antimicrobial days of therapy (DOT) and ID consultation by attributed provider type in 3 hospitals.

Methods: We performed a retrospective time series analysis of antimicrobial use and ID consultation from July 2015 to June 2022 at a major university hospital and 2 community hospitals. We evaluated antimicrobial DOT and ID consultation over time and assessed attribution to 3 groups of providers: attending physicians, trainees, and APPs. We used multinomial logistic regression to measure changes in percentage of DOT and ID consultation across the clinician groups over time using physicians as the referent.

Results: Baseline distribution of antimicrobial DOT and ID consultation varied by practice setting, but all subgroups showed increases in the proportion attributable to APPs. Large increases were seen in the rate of ID consultation, increasing by >30% during the study period. At our university hospital, by study end >40% of new ID consults and restricted antimicrobial days were attributed to APPs.

Conclusions: Hospitals had differing baseline patterns of DOT attributed to provider groups, but all experienced increases in DOT attributed to APPs. Similar increases were seen in changes to ID consultation. APPs have increasing involvement in antimicrobial use decisions in the inpatient setting and should be engaged in future antimicrobial stewardship initiatives.

Keywords: ID consultaiton; advanced practice provider; antimicrobial days of therapy; antimicrobial stewardship; interdisciplinary teams.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest.

Figures

Figure 1.
Figure 1.
Shifts in provider type attribution of antimicrobial days of therapy and infectious diseases (ID) consults at 3 hospitals. APP, advanced practice provider.
See this image and copyright information in PMC

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References

    1. McGrath BA, Jacobs ML, Watts RM, Callender BC. Developing and sustaining advanced practice provider services: a decade of lessons learned. J Hosp Med 2022; 17:1014–20. - PMC - PubMed
    1. Kleinpell RM, Grabenkort WR, Kapu AN, Constantine R, Sicoutris C. Nurse practitioners and physician assistants in acute and critical care: a concise review of the literature and data 2008–2018. Crit Care Med 2019; 47:1442–9. - PMC - PubMed
    1. Glotzbecker BE, Yolin-Raley DS, DeAngelo DJ, Stone RM, Soiffer RJ, Alyea EP. Impact of physician assistants on the outcomes of patients with acute myelogenous leukemia receiving chemotherapy in an academic medical center. J Oncol Pract 2013; 9:e228–33. - PubMed
    1. Landsperger JS, Semler MW, Wang L, Byrne DW, Wheeler AP. Outcomes of nurse practitioner–delivered critical care. Chest 2016; 149:1146–54. - PMC - PubMed
    1. Sawatzky J-AV, Christie S, Singal RK. Exploring outcomes of a nurse practitioner-managed cardiac surgery follow-up intervention: a randomized trial. J Adv Nurs 2013; 69:2076–87. - PubMed