The role of the cardiac surgical nurse practitioners in task shifting for efficient care in Japan

Purpose: Nurse practitioners (NPs) were introduced in Japan to reduce physicians’ workloads through task shifting. Three cardiac surgical NPs (CSNPs) were employed in our department. This study aimed to describe their clinical practices and evaluate their contributions to task shifting. Methods: We reviewed the medical records of patients treated between January 2019 and December 2024. Three analyses were conducted: (I) quantification of medical procedures performed by CSNPs, (II) assessment of CSNP participation as surgical assistants, and (III) evaluation of delegated medical order entries. Results: (I) Among 1,822 patients, the most frequently performed CSNP procedures were ventilator setting adjustments, peripherally inserted central catheter placement, and arterial blood sampling. (II) The median annual number of surgeries involving CSNPs was 191 (44%), with a median cumulative operative time of 1,137 h. (III) CSNP-delegated orders accounted for 19.2% of outpatient and 36.6% of inpatient entries. Increased CSNP order entries were significantly correlated with decreased surgeon entries in both outpatient (r = 0.67, p < 0.001) and inpatient (r = 0.59, p < 0.001) settings. Conclusions: The inverse correlation between CSNP and surgeon order entries indicates that CSNPs substantially support task shifting and help reduce surgeons’ workloads in cardiac surgery.