Abstract
Aim: To outline the successful development and implementation of a nurse practitioner role within a professional ballet school.
 Background: Nurse practitioners are well integrated into primary and acute care in Ontario, yet the role within schools and private athletic institutions is not well documented. Canada’s National Ballet School is a professional ballet school with a combination of day students and those living in residences. Students complete both dance training and academics at the School. The physical and mental health of students was identified as a key priority by the school, leading to the development of an integrated health and wellness program. To facilitate more timely access to healthcare and provide an opportunity for collaboration and consultation within the school, a plan to implement a nurse practitioner role into the school was developed.
 Methods: In order to develop and implement the role of the nurse practitioner within the institution, the participatory, evidence-based, patient-focused process for advanced practice nursing role development, implementation, and evaluation (PEPPA) framework was used. The first seven steps of the PEPPA framework were applied in this project.
 Findings: The PEPPA framework allowed for us to identify key barriers and facilitators for the role implementation and successfully implement the nurse practitioner role. While the initial plan was for a slower implementation, the COVID-19 pandemic highlighted the need for a nurse practitioner in the institution more urgently.
 Conclusion: The PEPPA framework provided us with an organized process for developing and implementing the nurse practitioner role at Canada’s National Ballet School.
Highlights
Canada’s National Ballet School (NBS) is recognized internationally for its professional ballet and academic program
The purpose of this paper is to describe the implementation of the Nurse practitioners (NPs) role within NBS using the PEPPA framework
The PEPPA framework has been used internationally to introduce and implement the role of Advanced practice nurse (APN) in various healthcare systems (Bryant-Lukosius et al, 2016), to our knowledge this is the first time it has been used in a private, dance and academic institute
Summary
Canada’s National Ballet School (NBS) is recognized internationally for its professional ballet and academic program. Youth attending boarding schools experience a separation from their home environment. While this transition for most can promote personal growth, for some it can be disruptive (Gottlieb, 2001). Youth who live away from home may not be aware of, or be able to independently recognize their emotional difficulties or physical illnesses, relying more on the support from adults at the school (Pavletic et al, 2016). While most healthcare issues affecting youth relate to acute episodic illness or injury and preventative care, elite dancers may experience additional healthcare issues. Injury and the duration of recovery, plus the frequency of injury have been linked to increased stress, anxiety, depression, and fatigue in ballet dancers (Alimena et al, 2016; Jacobs et al, 2012; Noh, 2005)
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