The Patient Care Strategy Employed by Nurse Practitioners Involves Work Sharing: As Demonstrated by the Use of Peripherally Inserted Central Catheters

Deaths due to overwork, known as Karoshi-death, among physicians have become an urgent problem to be solved in the healthcare sector. To improve the overwork environment, the Physician Workstyle Reform (PWR) Act was introduced in Japan in April 2024. To determine whether peripherally inserted central catheter (PICC) insertion by NPs would be a concrete solution required by the PWR Act, in this study, 214 PICCs were inserted in the uoroscopy room of the study hospital between April 2022 and March 2023, of which 214 were inserted in the basilic vein. Dividing the subjects into two PICC insertion groups, with eight physicians (group P, n=20) and one NP (group NP, n=50), As the results, (1) In group P, there was a correlation between years of experience and PICC insertion time (PIT). Regression line using the formula (PIT = -0.862 * (YAP) + 27.102), (2) No difference in the incidence of CRBSI, PICC indwelling days, and mortality. From the results, we conclude that there were no disadvantages in insertion time, CRBSI incidence, and mortality in the NP groups. This suggests that substituting NPs for physician-assisted PICC insertion has the potential to prevent Karoshi-deaths and provides a concrete example of PCR Acts. This suggestion for improving physician overwork could be extended to overwork in other health care professions, and work shifting of certain tasks could be a potential solution.