USE OF PEDIATRIC PHYSICIAN EXTENDERS IN PEDIATRIC AND NEONATAL INTENSIVE-CARE UNITS

Objectives: To determine present and future use of pediatric physician extenders in neonatal and pediatric intensive care units (ICUs). Desi gn: Descriptive, prospective, questionnaire survey. Participants: One hundred thirty hospitals represented by members of the Pediatric Secti on of the Society of Critical Care Medicine and 18 randomly selected h ospitals identified as having no pediatric intensivist. Interventions: None. Measurements and Main Results: One hundred one (68.2%) of 148 r esponding institutions employed physician extenders and 69 (46.7%) emp loyed pediatric physician extenders. Eighty percent of the hospitals u sing pediatric physician extenders employed pediatric nurse practition ers and 25% employed physician assistants. Of the 69 hospitals that em ployed pediatric physician extenders, 51 (73.9%) hospitals utilized th em in neonatal ICUs and 12 (17.4%) hospitals used them in the pediatri c ICUs. Institutions that did or did not employ pediatric physician ex tenders in pediatric ICUs were comparable in all factors studied, exce pt for the perception of childcare physician staffing shortages. Dutie s competently performed by pediatric physician extenders did not diffe r between pediatric nurse practitioners and physician assistants and w ere similar to those duties of a second-year pediatric resident. More than 40% of institutions expected to increase the use of pediatric phy sician extenders in neonatal and pediatric ICUs and they expected to p rovide the majority of the specialty training required. Conclusions: P ediatric physician extenders are extensively employed in pediatric and neonatal ICUs. They are perceived to perform at the level of second-y ear pediatric residents and are strongly supported by staff physicians and residents. It appears that more pediatric physician extenders wil l be employed in pediatric and neonatal ICUs in the future.