The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner
Due to time constraints, fewer physicians are performing large volume paracentesis (LVP) resulting in a longer wait time and more emergency department (ED) and hospital admissions. At our institution, after initial supervision, a certified nurse practitioner (NP) has independently performed LVP in a...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2009-10-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119317508 |
| _version_ | 1798032937009020928 |
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| author | Nooman Gilani Nayan Patel Richard D Gerkin Francisco C Ramirez Erin E Tharalson Kandarp Patel |
| author_facet | Nooman Gilani Nayan Patel Richard D Gerkin Francisco C Ramirez Erin E Tharalson Kandarp Patel |
| author_sort | Nooman Gilani |
| collection | DOAJ |
| description | Due to time constraints, fewer physicians are performing large volume paracentesis (LVP) resulting in a longer wait time and more emergency department (ED) and hospital admissions. At our institution, after initial supervision, a certified nurse practitioner (NP) has independently performed LVP in a dedicated cirrhosis clinic. The purpose of our study was to evaluate the feasibility and safety of LVP performed by a NP. A retrospective review of patients undergoing LVP between January 2003 and May 2007 was performed. Baseline patient information and the practitioner performing LVP (physician or NP) were recorded. Complications including post paracentesis hypotension, bleeding, local leakage of ascitic fluid, infection, perforation, and death were compared between the two groups. A total of 245 procedures in 41 patients were performed by a single NP, and 244 in 43 patients by physicians. Baseline characteristics of patients undergoing LVP were similar in two groups. Alcohol was the most common etiology of cirrhosis (46% in NP and 51% in physician group) followed by a combination of alcohol plus HCV (37% in NP and 28% in physician group). There was similar distribution of Childs class B and C patients in the two groups, as well as average MELD score. Total volume of ascites removed, number of needle attempts, and complications including post paracentesis hypotension, local leakage of ascitic fluid, bleeding, infection, and death were not statistically different between the two groups. Our study shows no difference between physician and NP performance of LVP and complication rates. LVP performed by a NP is feasible and has acceptable rate of complications. |
| first_indexed | 2024-04-11T20:20:56Z |
| format | Article |
| id | doaj.art-f791aad3800146ca878e9600de4ff13f |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-11T20:20:56Z |
| publishDate | 2009-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-f791aad3800146ca878e9600de4ff13f2022-12-22T04:04:48ZengElsevierAnnals of Hepatology1665-26812009-10-0184359363The safety and feasibility of large volume paracentesis performed by an experienced nurse practitionerNooman Gilani0Nayan Patel1Richard D Gerkin2Francisco C Ramirez3Erin E Tharalson4Kandarp Patel5Department of Gastroenterology and Hepatology, Carl. T. Hayden VA Medical Center, Phoenix, Arizona, USA 85012; Correpondence and reprint request:Department of Gastroenterology and Hepatology, Carl. T. Hayden VA Medical Center, Phoenix, Arizona, USA 85012Department of Gastroenterology and Hepatology, Carl. T. Hayden VA Medical Center, Phoenix, Arizona, USA 85012Department of Gastroenterology and Hepatology, Carl. T. Hayden VA Medical Center, Phoenix, Arizona, USA 85012Department of Gastroenterology and Hepatology, Carl. T. Hayden VA Medical Center, Phoenix, Arizona, USA 85012Department of Gastroenterology and Hepatology, Carl. T. Hayden VA Medical Center, Phoenix, Arizona, USA 85012Due to time constraints, fewer physicians are performing large volume paracentesis (LVP) resulting in a longer wait time and more emergency department (ED) and hospital admissions. At our institution, after initial supervision, a certified nurse practitioner (NP) has independently performed LVP in a dedicated cirrhosis clinic. The purpose of our study was to evaluate the feasibility and safety of LVP performed by a NP. A retrospective review of patients undergoing LVP between January 2003 and May 2007 was performed. Baseline patient information and the practitioner performing LVP (physician or NP) were recorded. Complications including post paracentesis hypotension, bleeding, local leakage of ascitic fluid, infection, perforation, and death were compared between the two groups. A total of 245 procedures in 41 patients were performed by a single NP, and 244 in 43 patients by physicians. Baseline characteristics of patients undergoing LVP were similar in two groups. Alcohol was the most common etiology of cirrhosis (46% in NP and 51% in physician group) followed by a combination of alcohol plus HCV (37% in NP and 28% in physician group). There was similar distribution of Childs class B and C patients in the two groups, as well as average MELD score. Total volume of ascites removed, number of needle attempts, and complications including post paracentesis hypotension, local leakage of ascitic fluid, bleeding, infection, and death were not statistically different between the two groups. Our study shows no difference between physician and NP performance of LVP and complication rates. LVP performed by a NP is feasible and has acceptable rate of complications.http://www.sciencedirect.com/science/article/pii/S1665268119317508ParacentesisAscitesCirrhosisNurse practitioner’s role |
| spellingShingle | Nooman Gilani Nayan Patel Richard D Gerkin Francisco C Ramirez Erin E Tharalson Kandarp Patel The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner Annals of Hepatology Paracentesis Ascites Cirrhosis Nurse practitioner’s role |
| title | The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner |
| title_full | The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner |
| title_fullStr | The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner |
| title_full_unstemmed | The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner |
| title_short | The safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner |
| title_sort | safety and feasibility of large volume paracentesis performed by an experienced nurse practitioner |
| topic | Paracentesis Ascites Cirrhosis Nurse practitioner’s role |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119317508 |
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