Appropriate performance of separate reserved procedures
NP | PA | |||||
T0 | T1 | T2 | T0 | T1 | T2 | |
Cardioversion/defibrillation* | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 23 (5.2) | 1 (0.6) | 15 (6.1) | 12 (12.6) | 16 (8.4) | 27 (10.6) |
Catheterisation | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 69 (15.5) | 29 (17.0) | 53 (21.7)† | 24 (25.3) | 33 (17.4) | 68 (26.7) |
Mean (95% CI) number of monthly performed procedures by NP/PA | 16.2 (10.3 to 22.1) | 14.0 (9.4 to 18.7) | 23.0 (15.6 to 30.3) | 15.2 (10.0 to 20.5) | 19.0 (11.3 to 26.6) | 23.0 (15.7 to 30.5) |
% procedures performed on authorisation of NP/PA | 65.3 | 75.5 | 81.9 | 81.2 | 83.9 | 78.5 |
+Without consultation | 43.0 | 57.1 | 65.6 | 56.5 | 75.8 | 65.2 |
++Delegation to other care provider | 1.7 | 21.8 | 34.4† | 0.0 | 42.5 | 33.7† |
Mean (95% CI) duration of a single performed procedure by NP/PA (min)‡ | 13.4 (11.9 to 15.0) | 11.6 (10.1 to 13.1) | 9.2 (8.1 to 10.2)§ | 10.3 (8.9 to 11.7) | 8.3 (7.1 to 9.4) | 7.2 (6.2 to 8.2)§ |
Mean (95% CI) number of monthly contact physicians—NP/PA about the procedure¶ | 23.3 (9.8 to 36.7) | 15.0 (7.4 to 22.7) | 12.0 (2.0 to 22.0) | 25.7 (15.5 to 35.9) | 33.6 (13.7 to 53.6) | 16.0 (2.9 to 29.1) |
% contacts on physician’s assignment of the procedure to the NP/PA¶ | 69.1 | 52.2 | 70.6 | 56.0 | 57.4 | 62.5 |
Mean (95% CI) physician’s assignment time (min)¶ | 3.3 (1.0 to 5.0) | 6.6 (2.5 to 10.0) | 8.2 (6.1 to 10.0)§ | 3.2 (1.3 to 4.6) | 6.1 (4.3 to 10.0) | 7.9 (4.9 to 9.4)§ |
Endoscopy* | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 9 (2.0) | 6 (3.5) | 9 (3.7) | 8 (8.4) | 14 (7.4) | 21 (8.2) |
Injection | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 208 (46.8) | 75 (43.9) | 124 (50.8) | 64 (67.4) | 132 (69.5) | 178 (69.8) |
Mean (95% CI) number of monthly performed procedures by NP/PA | 18.3 (10.4 to 26.2) | 24.4 (14.0 to 34.2) | 25.2 (17.0 to 33.5) | 19.8 (13.3 to 26.2) | 26.6 (15.7 to 36.9) | 37.2 (27.5 to 47.6)§ |
% procedures performed on authorisation of NP/PA | 54.0 | 64.4 | 68.7 | 66.7 | 76.7 | 79.6 |
+Without consultation | 30.7 | 42.5 | 47.2 | 38.7 | 54.7 | 56.5 |
++Delegation to other care provider | 0.7 | 13.1 | 19.4† | 0.5 | 16.9 | 14.8† |
Mean (95% CI) duration of a single performed procedure by NP/PA (min)‡ | 7.8 (6.7 to 8.8) | 6.3 (5.4 to 7.2) | 7.4 (6.5 to 8.3) | 7.3 (6.4 to 8.3) | 6.2 (5.3 to 7.0) | 5.6 (4.7 to 6.4)§ |
Mean (95% CI) number of monthly contact physicians—NP/PA about the procedure¶ | 18.1 (10.5 to 25.6) | 15.3 (8.5 to 22.2) | 15.5 (6.9 to 24.2) | 19.1 (11.7 to 26.5) | 21.4 (8.1 to 34.7) | 29.5 (8.6 to 50.4) |
% contacts on physician’s assignment of the procedure to the NP/PA¶ | 80.6 | 60.5 | 50.0† | 52.4 | 60.8 | 47.7 |
Mean (95% CI) physician’s assignment time (min)¶ | 2.6 (0.5 to 5.0) | 4.8 (4.4 to 5.0) | 7.1 (5.1 to 15.0)§ | 2.6 (1.7 to 3.0) | 2.5 (1.3 to 3.5) | 6.3 (5.6 to 10.3)§ |
Prescribing | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 245 (55.2) | 134 (78.4) | 177 (72.5)† | 55 (57.9) | 148 (77.9) | 208 (81.6)† |
Mean (95% CI) number of monthly performed procedures by NP/PA | 52.7 (41.2 to 64.1) | 46.2 (37.7 to 54.8) | 49.5 (42.5 to 56.5) | 74.7 (59.6 to 89.8) | 87.3 (66.1 to 108.5) | 76.8 (62.7 to 89.8) |
% procedures performed on authorisation of NP/PA | 65.7 | 75.7 | 74.5† | 66.5 | 79.6 | 67.1 |
+Without consultation | 27.3 | 51.6 | 51.0† | 35.8 | 52.1 | 45.6† |
++Delegation to other care provider | 1.6 | 3.9 | 5.0† | 0.0 | 9.3 | 2.9† |
Mean (95% CI) duration of a single performed procedure by NP/PA (min)‡ | 7.2 (6.5 to 7.9) | 6.3 (5.6 to 6.9) | 7.2 (6.7 to 7.6) | 4.3 (3.8 to 4.7) | 4.5 (4.0 to 5.0) | 3.5 (3.3 to 3.8) |
Mean (95% CI) number of monthly contact physicians—NP/PA about the procedure¶ | 70.9 (46.3 to 95.5) | 58.0 (40.2 to 75.9) | 46.8 (30.1 to 63.5) | 74.6 (54.5 to 94.6) | 64.6 (41.2 to 88.1) | 57.2 (37.5 to 76.9) |
% contacts on physician’s assignment of the procedure to the NP/PA¶ | 53.5 | 57.2 | 31.4† | 54.1 | 47.7 | 54.6 |
Mean (95% CI) physician’s assignment time (min)¶ | 4.1 (1.0 to 5.0) | 4.6 (4.2 to 5.0) | 4.1 (3.9 to 4.3) | 2.2 (1.8 to 2.5) | 3.2 (2.7 to 3.9) | 3.6 (3.3 to 3.8)§ |
Puncture | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 88 (19.8) | 32 (18.7) | 51 (20.9) | 41 (43.2) | 102 (53.7) | 135 (52.9) |
Mean (95% CI) number of monthly performed procedures by NP/PA | 14.7 (8.9 to 20.5) | 11.8 (5.7 to 17.0) | 11.8 (7.5 to 15.8) | 9.5 (5.7 to 13.3) | 18.2 (11.8 to 24.6) | 19.6 (12.5 to 26.8)§ |
% procedures performed on authorisation of NP/PA | 55.8 | 64.9 | 74.1 | 72.0 | 69.4 | 70.8 |
+Without consultation | 32.6 | 43.2 | 46.9 | 45.3 | 51.8 | 47.2 |
++Delegation to other care provider | 0.0 | 2.7 | 16.0† | 0.0 | 18.8 | 14.6† |
Mean (95% CI) duration of a single performed procedure by NP/PA (min)‡ | 13.5 (10.9 to 16.0) | 11.1 (7.8 to 14.4) | 13.0 (10.1 to 15.8) | 11.1 (9.3 to 13.0) | 11.3 (9.2 to 13.3) | 11.0 (8.4 to 13.6) |
Mean (95% CI) number of monthly contact physicians—NP/PA about the procedure¶ | 26.9 (14.9 to 38.9) | 10.2 (2.7 to 17.6) | 6.9 (2.2 to 11.5)§ | 13.9 (9.6 to 18.1) | 11.1 (2.6 to 19.6) | 6.3 (3.7 to 8.9)§ |
% contacts on physician’s assignment of the procedure to the NP/PA¶ | 78.6 | 56.5 | 28.6† | 64.3 | 53.3 | 67.7 |
Mean (95% CI) physician’s assignment time (min)¶ | 3.9 (0.5 to 5.0) | 14.3 (5.0 to 10.4) | 10.5 (7.3 to 17.5)§ | 2.5 (1.3 to 5.0) | 4.2 (1.0 to 7.8) | 9.2 (5.3 to 13.5)§ |
Small surgical procedure | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 99 (22.3) | 41 (24.0) | 76 (31.1)† | 36 (37.9) | 88 (46.3) | 135 (52.9)† |
Mean (95% CI) number of monthly performed procedures by NP/PA | 10.5 (7.1 to 13.9) | 11.8 (6.5 to 17.0) | 15.1 (9.0 to 21.2) | 15.5 (9.3 to 20.9) | 17.0 (10.6 to 23.4) | 30.0 (22.8 to 38.3)§ |
% procedures performed on authorisation of NP/PA | 62.7 | 82.8 | 88.7† | 60.9 | 72.4 | 68.2 |
+Without consultation | 40.0 | 64.4 | 68.1† | 32.4 | 45.9 | 47.0 |
++Delegation to other care provider | 1.8 | 2.3 | 15.7† | 0.0 | 11.0 | 10.3† |
Mean (95% CI) duration of a single performed procedure by NP/PA (min)‡ | 16.0 (13.8 to 18.3) | 14.5 (12.1 to 16.8) | 13.6 (12.1 to 15.1) | 16.0 (13.8 to 18.2) | 13.8 (12.3 to 15.3) | 13.9 (12.6 to 15.3) |
Mean (95% CI) number of monthly contact physicians—NP/PA about the procedure¶ | 20.1 (7.5 to 32.7) | 17.1 (8.1 to 26.1) | 19.3 (8.5 to 30.1) | 30.9 (20.0 to 41.8) | 7.9 (3.9 to 12.0) | 14.1 (8.7 to 19.5)§ |
% contacts on physician’s assignment of the procedure to the NP/PA¶ | 70.7 | 48.7 | 47.1† | 53.8 | 61.5 | 47.4 |
Mean (95% CI) physician’s assignment time (min)¶ | 4.6 (1.0 to 5.0) | 5.0 (3.9 to 8.2) | 6.9 (4.8 to 8.8) | 6.4 (1.3 to 7.8) | 8.0 (2.9 to 6.8) | 10.5 (8.0 to 15.0)§ |
Total of above procedures | ||||||
n (%) NPs/PAs, performing the procedure (quick scan) | 341 (76.6) | 152 (88.9) | 207 (84.8)† | 82 (86.3) | 178 (93.7) | 236 (92.5) |
Mean (95% CI) number of monthly performed procedures by NP/PA | 80.5 (64.6 to 96.3) | 71.8 (58.2 to 85.3) | 77.4 (65.7 to 89.2) | 119.8 (97.6 to 142.1) | 141.6 (106.8 to 176.4) | 133.2 (111.7 to 154.8) |
% procedures performed on authorisation of NP/PA | 63.0 | 74.3 | 76.1† | 66.7 | 77.1 | 71.1 |
+Without consultation | 31.9 | 51.9 | 54.2† | 38.4 | 55.2 | 50.8† |
++Delegation to other care provider | 1.7 | 7.5 | 13.0† | 0.1 | 17.9 | 12.4† |
Mean (95% CI) duration of a single performed procedure by NP/PA (min)‡ | 9.9 (9.3 to 10.5) | 8.1 (7.5 to 8.6) | 8.6 (8.2 to 9.0)§ | 8.8 (8.1 to 9.4) | 8.1 (7.6 to 8.7) | 7.4 (6.9 to 7.8)§ |
Mean (95% CI) number of monthly contact physicians—NP/PA about the procedure¶ | 81.2 (58.2 to 104.3) | 60.7 (44.7 to 76.7) | 49.1 (35.1 to 63.0) | 107.2 (82.9 to 131.5) | 67.5 (48.7 to 86.3) | 53.9 (38.6 to 69.3)§ |
% contacts on physician’s assignment of the procedure to the NP/PA¶ | 64.8 | 56.2 | 41.5† | 55.4 | 55.6 | 54.7 |
Mean (95% CI) physician’s assignment time (min)¶ | 3.8 (1.0 to 5.0) | 6.3 (2.0 to 10.0) | 5.9 (1.6 to 10.0)§ | 3.5 (0.5 to 5.0) | 4.3 (1.0 to 5.0) | 6.6 (2.0 to 10.0)§ |
*Lack of data about the mean (95% CI) number of monthly performed procedures by NP/PA; % procedures performed on authorisation of NP/PA; mean (95% CI) duration of a single performed procedure by NP/PA; mean (95% CI) number of physicians noted contacts with NP/PA about the procedure and % physicians noted contacts on an assignment of the procedure to the NP/PA.
†Statistically significant difference between T0 and T2 (X2(1) p<0.05).
‡Including consultation or assignment time.
§Statistically significant difference between T0 and T2 (Mann-Whitney U test p<0.05).
¶Physician’s perspective.
NP, nurse practitioner; PA, physician assistant.