The role of advanced practice nurses in transplant center staffing.

CONTEXT Despite increased rates of solid organ transplantation and frequent use of advanced practice nurses (APNs) to manage patients, no established staffing model including APNs and their roles exists. OBJECTIVE To characterize the role and integration of APNs in the staffing models of existing transplant centers. DESIGN Descriptive research using a researcher-designed survey of transplant APN professionals. PARTICIPANTS 53 attendees of a national APN transplant clinical management symposium. MAIN OUTCOME MEASURE Investigator-designed survey tool consisting of 21 questions delivered in a paper format with 1 open-ended question about adequacy of current staffing and ideas for improvement. RESULTS 53 responses from staff members of 21 different transplant centers were collected. In addition to APNs, members of existing transplant staffing models were identified as licensed practical nurses, registered nurses, social workers, administrative assistants, and data managers. The primary responsibilities of APNs were both inpatient and outpatient, before and after transplant, and consisted primarily of collecting patients' medical histories, doing physical examinations, handling clinic visits, and education. Licensed practical and registered nurses handled pre-transplant referral management and phone triage duties. Social workers, administrative assistants, and data managers were responsible for social support, medical record management, and regulatory documentation, respectively. Most respondents (57%) found current staffing to be inadequate in their centers and suggested areas for improvement. CONCLUSION APNs play a vital role in management of transplant patients. Transplant centers use APNs in different capacities, depending on the individual needs of the institution. Across institutions, support staff is crucial in the perception of adequate staffing. Additional research is needed to determine the most efficient use of APNs in transplant centers.