ArticleAmerican journal of critical care : an official publication, American Association of Critical-Care Nurses2025
Availability of Advanced Practice Providers in Adult Intensive Care Units in the United States: A Survey.
Article in American journal of critical care : an official publication, American Association of Critical-Care Nurses, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- "I feel abandoned by nursing and not accepted by medicine": Factors undermining a healthy work environment for hospital-based nurse practitioners in the United States.Journal of the American Association of Nurse Practitioners · 2026Article
- The intensive care unit balancing act: integrated staffing models for better patient ratios.Critical care science · 2026Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundHow advanced practice providers (APPs) are deployed in adult US intensive care units (ICUs) is understudied. Further, whether state-level restrictions on practice affect the availability of these providers is unknown.
objectivesTo describe staffing patterns of ICU APPs (nurse practitioners, physician assistants) in the context of physicians-in-training (interns, residents, fellows) and to explore the association between state-level APP practice restrictions and employment.
methodsData from a national survey of pre-COVID-19 (steady-state) ICU staffing linked to the 2020 American Hospital Association survey were used to examine staffing patterns (via descriptive statistics) and to explore the association of state-level practice restrictions with the presence of APPs in ICUs (via multivariable regression).
resultsThe cohort included 588 adult ICUs, of which 336 (57.1%) reported both APPs and physicians-in-training, 124 (21.1%) APPs only, 73 (12.4%) physicians-in-training only, and 55 (9.4%) neither. Units with both provider types were more commonly surgical ICUs (17.6% vs ≤9.6%; P < .001), whereas those with neither were 98.2% mixed units. Those units with neither were smaller and more often in smaller, nonteaching, for-profit hospitals in nonmetropolitan areas. Two hundred twenty-five ICUs (38.3%) were in states allowing full APP practice scope. After adjustment, the odds of employing APPs were nonsignificantly higher in ICUs in full-practice states.
conclusionsBoth APPs and physicians-in-training are commonly deployed in US adult ICUs, often together. Laws limiting practice scope may impede deployment of these providers in ICUs.
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