Acute care pediatric nurse practitioners: providing quality care for acute and critically ill children

A curriculum to improve knowledge and skills of nurse practitioners and physician assistants in the pediatric emergency department

ABSTRACT

Nurse practitioners (NPs) and physician assistants (PAs) have an important role in delivery of care in a tertiary children's hospital emergency department (ED). Most NPs and PAs have not had any formal training to work in a pediatric ED; although our NPs and PAs had no formal ED training, some were acute care certified. We describe a curriculum designed to improve knowledge and skills of NPs and PAs in the pediatric ED. The curriculum consists of three modules, namely, online lecture series, procedural workshops, and case scenarios in a simulated setting. Module 1 consisted of online lecture on 10 common ED diagnoses. The second module consisted of procedural workshops on lumbar puncture, incision and drainage of abscesses, gastrostomy insertion, and laceration repair. The third module included simulation scenarios on ED-specific cases of seizure in an infant, bronchiolitis and ruptured appendicitis with shock. Each module was evaluated by a survey. Participants rated each item on the survey using a Likert scale response (1 = disagree completely to 5 = agree completely). Both NPs and PAs demonstrated increase in knowledge scores in posttest 1 vs pretest (p < .001) and did not show a significant decline in posttest 2 (p = .073). The mean ratings of components of the online lecture series, workshops, and simulation scenarios were 4.5-4.7, 4.4-4.8, and 4.5-4.7, respectively, with positive comments. This novel curriculum meets the educational needs of NPs and PAs at our institution and can be used as a model to train them at other tertiary care pediatric EDs.

Acute Care Pediatric Nurse Practitioner: The 2018 Practice Analysis

INTRODUCTION

Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study informed an update of the Certified Pediatric Nurse Practitioner - Acute Care (CPNP-AC) examination content outline.

METHOD

A descriptive analysis of a survey completed in 2018 by 373 pediatric nurse practitioners (PNP) practicing as an acute care role (AC).

RESULTS

Respondents were primarily females aged 25 to 34 years (35.4%) and formally educated as AC PNPs (84.2%) and held the CPNP-AC credential (98.9%). Most respondents (83.6%) practiced in urban areas and spent 84% of their time in direct patient care with 74% working in inpatient settings. The majority (87%) worked in subspecialty practice such as critical care (18.5%) and cardiac intensive care (12.3%).

DISCUSSION

This is the fourth practice analysis of the AC PNP role that demonstrates continuous evolution in clinical practice, educational preparation, and subspecialty practice distribution.

Acute care pediatric nurse practitioner: a practice analysis study

INTRODUCTION

It is the responsibility of certification organizations to provide psychometrically sound and legally defensible examinations. Practice research serves as the certification framework for validating advanced practice roles and updating national qualifying examinations. This national study describes the practice of the acute care pediatric nurse practitioner (ACPNP) since the inception of the certified pediatric nurse practitioner-acute care (CPNP-AC) examination in 2005.

METHOD

A descriptive analysis of the 2009 practice survey of U.S. ACPNPs (291 respondents) was performed.

RESULTS

Most ACPNP respondents were White women; the mean age was 40 years, and 47.9% had been formally educated as ACPNPs. More than 40% practiced in the Midwestern United States. Most respondents (86.2%) practiced in urban areas. Respondents reported spending 71% of practice time in inpatient settings. The most frequently cited areas of practice were critical care (27.5%), followed by emergency department (10.7%) and specialty practices.

DISCUSSION

In light of recent advanced practice regulatory role distinctions, this re-examination of the ACPNP practice 5 years after initiation of the CPNP-AC certification examination demonstrates changes in clinical practice and educational preparation requirements.

The evolution of pediatric critical care nursing: past, present, and future

Although current nursing literature is overflowing with information related to the history of nursing in general, and even pediatric nursing, very little is published about PICU nursing. The evolution of pediatric critical care nursing is presented based on a historical context, the current state, and future projections. More specifically, this treatise focuses on the environment, the patient and family, and of course, the PICU nurse. Concluding remarks provide an insight into how health care reforms and how the use of clinical information technology will affect the role of the pediatric critical care nurse in the future.

Acute care pediatric nurse practitioner: a vital role in pediatric cardiothoracic surgery

The changing health care environment and provider shortage have required acute care pediatric nurse practitioners (AC PNPs) to play a vital role in hospital-based, subspecialty surgical services. The AC PNP is part of a multidisciplinary team providing care for children with congenital heart disease after heart surgery. The AC PNP provides high-quality, cost-effective care to acute and critically ill children, optimizing hospital throughput while ensuring patient safety. This article focuses on the history and emerging role of the AC PNP in the context of the Magnet component of transformational leadership, the physician/nurse practitioner collaborative practice, and the development of the AC PNP role in cardiothoracic surgery at the Children's Hospital Los Angeles.

Professional development for an advanced practice nursing team

Since its development in 1998, the Cardiology Advanced Practice Nurse team has been plagued by retention issues. The coordinator for the team developed this leadership project while participating in the 2008 to 2009 Maternal-Child Health Leadership Academy sponsored by Sigma Theta Tau International and Johnson & Johnson. The focus of this project was to develop, implement, and evaluate initiatives to empower the advanced practice nurse team, promote their professional development, and ultimately improve retention of team members. Although evaluation data show progress toward addressing work environment issues, retention remains an ongoing problem.

Onboarding advanced practice nurses: development of an orientation program in a cardiac center

The advanced practice nurse (APN) is critical to continuity of patient care, particularly in an innovative and research-intensive environment. The intensity of the environment, steep learning curve, and lack of a structured orientation can lead to difficulties in role assimilation and feelings of disconnectedness. This led the authors to undertake an improvement project to develop an onboarding program for APNs and develop strategies to orient them to their role. The authors describe the program and discuss how it was perceived by the APNs. Program evaluation and suggestions for future nursing research are identified.

Pediatric nurse practitioner implementation of a pediatric trauma continuity clinic utilizing the "medical home" model

Trauma is the leading cause of pediatric morbidity and mortality in the United States. There are known gaps in access to pediatric trauma care and rehabilitation services. We postulate that aftercare is fragmented or nonexistent. We propose that postdischarge "medical home" style care, championed by a pediatric nurse practitioner, leads to improved short-term outcomes and caretaker and provider satisfaction.