Meeting the evolving demands of neurointervention: Implementation and utilization of nurse practitioners

Abstract

Growth in the neurointerventional field, as a result of the emergence of thrombectomy as the gold standard treatment for large vessel occlusions, has created complex challenges. In an effort to meet evolving demands and fill workflow gaps, nurse practitioners have taken on highly specialized roles. Neurointerventional care has rapidly evolved similarly to interventional cardiac care, in that nurse practitioners are successfully being incorporated as procedural assistants in catheterization laboratories. Similar utilization of nurse practitioners in interventional neuroradiology holds the capacity to decrease physician workload, mitigate stresses contributing to burn-out, and reallocate more physician time to procedures. Nurse practitioner practice faces procedural, clinical, legal and interpersonal barriers. Despite calls for expanded practice by the Institutes of Medicine, a paucity of nurse practitioner training opportunities exists. Fragmented privileging processes contribute to environments where nurse practitioners must navigate hurdles without established interventional neuroradiology-specific precedent. Increased nurse practitioner mentorship, fluoroscopy law standardization, physician support surrounding nurse practitioner autonomy, and role consistency is imperative for optimal nurse practitioner utilization. Nurse practitioners are uniquely equipped to bridge evolving gaps through the provision of safe, efficacious care, and generating revenue at lower costs. Discussion surrounding nurse practitioner use to bridge workflow gaps is an exciting opportunity for future practice development.