(63 - Friday) Pediatric Cardiac ICU APP Well-Being

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Abstract: Introduction/Objective
We found a paucity of research investigating well-being in Advanced Practice Providers (APPs) in pediatric cardiac intensive care (PCIC). Our primary objective was to evaluate APP Well-Being Index (WBI) scores and potential modifiable factors. Our secondary objective was to evaluate the effects of the COVID-19 pandemic on PCIC RNs.

Methods
Our mixed methods REDCap© survey was conducted between October 2021 and January 2022. We surveyed APPs in the United States (US) using the Collaborative Research from the Pediatric Cardiac Intensive Care Society (CoRe-PCICS). Our survey included the WBI, demographic data, specific questions regarding COVID-19, and open-ended questions. The WBI is a 9-item tool that predicts distress and well-being in US workers and has been validated in multiple health disciplines. A score of ≥ 4 for APPs represents an at-risk score. The WBI score and participant characteristics were described using mean and standard deviation (SD) for continuous variables or absolute counts with percentages for categorical variables. Differences in WBI scores between groups with differing responses were compared using student t-test and one-way ANOVA. A p-value < 0.05 was considered statistically significant. WBI scores are represented as (mean ± SD).

Results
Among 38 bedside PCIC APPs who completed the WBI, the mean WBI score was 2.18 ± 2.4, which is not an at-risk score. 15 APPs (39%) had a score of ≥4. 13 APPs (34%) reported an intent to leave their jobs (WBI 2.85±2.44). There was no significant difference in WBI between those with and without intent to vacate. 4 APPs (11%) who responded No to “did you have enough resources to do your job well before COVID” had WBI of 4.25±0.96, and 16 (46%) Yes respondents WBI was 0.88±2.45, p=0.006. 6 APPs (17%) who responded No to “do you have enough resources to do your job well during COVID” had WBI of 4.00±1.27, and 13 Yes respondents’ (36%) WBI was 0.15±2.15, p= < 0.001. 5 APPs (14%) who responded No to “do you feel supported by unit leadership” had WBI of 4.40±0.55, and 22 Yes respondents (59%) WBI was 1.18±2.52, p=0.005. 8 APPs (22%) who responded No to “do you feel supported by institutional leadership” had WBI of 3.38±2.00, and 15 Yes respondents (42%) WBI was 0.87±2.64, p=0.027. 7 APPs with a chronic health condition (18%) had WBI of 4.29±1.38, compared to 31 APPs without (82%), WBI of 1.71± 2.36, p=0.009. There were no significant differences in WBI among respondents between years of experience, age, gender, hospital region, unit type, shifts worked, participation in exercise or self-care activities, or availability of hospital wellness services.

Conclusions
This is the first study to our knowledge to evaluate well-being in PCIC APPs and results suggest APPs overall do not have high risk WBI scores, although 39% had an at-risk score. Further research is needed to determine modifiable factors to improve well-being among PCIC APPs in those with at risk scores. A follow-up survey focused on APPs with a larger number of centers would be beneficial to identify targeted interventions to improve well-being in PCIC APPs as needed and could identify if the COVID-19 pandemic contributed to at risk scores.