{"doi":"10.4037/ajcc2025655","title":"Availability of Advanced Practice Providers in Adult Intensive Care Units in the United States: A Survey","abstract":"BACKGROUND: How 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. OBJECTIVES: To 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. METHODS: Data 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). RESULTS: The 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. CONCLUSIONS: Both 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.","journal":"American Journal of Critical Care","year":2025,"id":526116,"datarank":0.20794415416798362,"base_score":1.3862943611198906,"endowment":1.3862943611198906,"self_citation_contribution":0.20794415416798362,"citation_network_contribution":0.0,"self_endowment_contribution":0.20794415416798362,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9517,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1215140,"name":"Danny Lizano","orcid":null,"position":1,"is_corresponding":false},{"id":736081,"name":"Allan Garland","orcid":"0000-0001-7129-936X","position":2,"is_corresponding":false},{"id":272519,"name":"Robert Fowler","orcid":"0000-0002-1002-2989","position":3,"is_corresponding":false},{"id":373990,"name":"Vincent X. Liu","orcid":"0000-0001-6899-9998","position":4,"is_corresponding":false},{"id":399727,"name":"Damon C. Scales","orcid":"0000-0001-7101-3958","position":5,"is_corresponding":false},{"id":272518,"name":"Hannah Wunsch","orcid":"0000-0001-5477-8422","position":6,"is_corresponding":false},{"id":644628,"name":"Hayley B. Gershengorn","orcid":"0000-0002-7360-2489","position":7,"is_corresponding":false},{"id":306811,"name":"Deena Kelly Costa","orcid":"0000-0002-7776-5349","position":0,"is_corresponding":true}],"reference_count":29,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:50:25.860105Z","pmid":"40583008","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}