Comparing health care outcomes before and after employing nurse practitioners in cardiovascular hospitals in Japan: A retrospective chart review

J Am Assoc Nurse Pract. 2024 Nov 1;36(11):629-636. doi: 10.1097/JXX.0000000000001046.

Abstract

Background: There are approximately 872 certified nurse practitioners (NPs) in Japan as of April 2024. However, research on the results of their specific activities is still scarce.

Purpose: This study aimed to compare health care outcomes before (i.e., 2019) and after (i.e., 2021) employing NPs in cardiovascular hospitals in Japan.

Methodology: We conducted a retrospective chart review and analyzed 114 patients who underwent cardiac surgery in Hospital A and 381 patients who received pacemaker implantation/replacement in Hospital B. Hospital A hired one NP for cardiac surgery service, and Hospital B hired one NP for pacemaker device service. The NPs assisted in the surgical procedures and provided postsurgical management.

Results: In Hospital A, the median length of hospitalization and intubation were shorter in 2021 than in 2019 ( p = .02 and .01, respectively). In Hospital B, medical fee reimbursement was lower in 2021 ( p < .001) than in 2019, and the median procedure duration was shorter ( p = .01), which remained statistically significant after controlling for age, comorbidities, and device types. Some outcomes improved following the employment of NPs, whereas others remained unchanged.

Conclusions: Nurse practitioners managed surgical patients well and contributed to the quality care of cardiovascular medicine.

Implications: The employment of NPs in Japan is encouraged because even a single NP can have a positive, although not large, impact on patients and organizations.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Japan
  • Male
  • Middle Aged
  • Nurse Practitioners* / statistics & numerical data
  • Nurse Practitioners* / trends
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / statistics & numerical data
  • Retrospective Studies