Pediatric Nurse Practitioners Research Articles

Analysis of education and previous nursing experience of certified PNPs in the United States

BackgroundEducational programs to prepare nurse practitioners (NPs) were historically built upon foundational nursing experience. Originally prepared as certificate programs in 1965, the educational requirements for nurse practitioners (NPs) rapidly shifted from certificate programs to the Master's degree (DellaBella, 2015; Fairman, 2008). As Doctor of Nursing Practice (DNP) degree programs increase in number, it is unknown whether this foundational nursing experience has changed, or if it differs by certification type for pediatric nurse practitioners (PNPs). This study aimed to evaluate the educational preparation and prior nursing experience of primary care and acute care certified PNPs. MethodsA national survey of members of the Pediatric Nurse Practitioner Certification Board (N = 17,530) was completed (Mudd et al., 2022). A sub-analysis of this data was conducted (n = 1974). Results: There was no statistical evidence among either primary or acute care PNPs of an association between previous nursing experience and type of degree preparation (Master's or DNP). There was only a weak association between educational preparation and experience among acute care nurse practitioners. Most respondents were prepared at the Master's level, and 85% of all respondents had >1 year of nursing experience prior to returning for additional PNP education. DiscussionThis study adds to the literature as it describes the educational preparation and foundational nursing experience of primary and acute care PNPs. It can serve as a benchmark as the move to the DNP continues for Advanced Practice Registered Nurse preparation.

An Innovative Educational Intervention for Pediatric Nurse Practitioner Faculty to Meet Social Justice Curriculum Standards

The association between adverse childhood experiences and negative health outcomes is a public health concern, particularly affecting disadvantaged groups and contributing to health disparities. Pediatric nurse practitioners are well-positioned to address this issue, emphasizing the importance of incorporating social justice concepts into nursing education to develop a pediatric workforce with the necessary skills to curb health disparities. However, evidence-based approaches to incorporating these concepts into pediatric nursing education are limited. To address this gap, we describe an innovative educational intervention that harnesses the power of narratives to empower future pediatric nurse practitioners as champions of social justice and health equity.

Through the Looking Glass: Diversity, Equity, Inclusion, and Belonging: A Call for Action from the National Association of Pediatric Nurse Practitioners

In response to growing health disparities, social inequities, structural racism, and discrimination, the National Association of Pediatric Nurse Practitioners established a Diversity, Equity, and Inclusion Taskforce. In 2020, this group transitioned into a national committee to infuse equity across the organization and empower pediatric-focused advanced practice registered nurses as agents of change to address health disparities. Emphasizing the critical need for understanding health disparities in the context of racism and discrimination, this committee champions a paradigm shift, transcending educational initiatives, advisory roles, advocacy efforts, leadership strategies, and community services to illuminate an equitable future for all children and families.

Recommended Childhood and Adolescent Immunization Schedule: United States, 2024.

The 2024 recommended childhood and adolescent immunization schedules have been approved by the Centers for Disease Control and Prevention (CDC), American Academy of Pediatrics (AAP), American Academy of Family Physicians, American College of Obstetricians and Gynecologists, American College of Nurse-Midwives, American Academy of Physician Associates, and National Association of Pediatric Nurse Practitioners. The schedules are revised annually to reflect current recommendations for the use of vaccines licensed by the US Food and Drug Administration.

The STAMPPed Initiative for Pediatric Nurse Practitioner Students.

As the demand for nurse practitioners increases to meet health care needs, pathways to facilitate the transition into specialty advanced practice nursing education must be developed. The STudent Advisor/Mentorship Program for Pediatrics (STAMPPed) program was an innovative strategy established to support graduate nursing students with little to no pediatric clinical experience who demonstrated an interest in becoming pediatric nurse practitioners. The program provided structured guidance and support from experienced pediatric nursing faculty through monthly group meetings and the formulation of one-to-one student-faculty mentoring dyads. Mentees found the program to be helpful and foster supportive relationships.

An Educational Quality Improvement Project to Enhance Culturally Appropriate Care by Pediatric Nurse Practitioner Students Using a Multimodal Approach

Cultural identity has a profound impact on the health of children. The delivery of culturally appropriate care is key to patient-centered care. To combat health inequities children face, nursing faculty must prepare students to provide culturally appropriate care. We conducted a quality improvement educational intervention to enhance pediatric nurse practitioner students' educational preparation in providing culturally appropriate care. The setting for this project was a large academic institution. This study aimed to evaluate a multimodal approach to educating nurse practitioner students on culturally appropriate care. A three-phase intervention was used to explore the impact of the multimodal approach. Surveys were used to explore the impact of each modality on the student's knowledge and confidence in delivering culturally appropriate care. Results suggest that a multimodal approach is an effective modality. Experiential learning opportunities are imperative to enhance the delivery of culturally appropriate care.

Pediatric nurse practitioner workforce shortage threatens child health equity: Key contributors and recommendations.

The pediatric nurse practitioner (PNP) workforce shortage has begun to limit access to providers participating in Medicaid and/or the Children's Health Insurance Program, threatening child health equity in the United States. The following are key contributors: an emphasis on adult-focused NP programs and subsequent reduction in undergraduate pediatric content, common practice of student advisement to choose family NP programs, decreased PNP student enrollment leading to nonurban pediatric program closures, an acute shortage of PNP preceptors, and invisibility of the PNP workforce in national workforce data and strategic planning. We outline feasible action steps that nurses, NPs, educators, physicians, and policymakers can take to support PNP workforce growth to advance child health equity in the United States.

The Cost of Caring During COVID-19: A Clarion Call to Action to Support the Pediatric Advanced Practice Nursing Workforce

This study reexamined the holistic impacts of COVID-19 on the pediatric advanced practice registered nursing (APRN) workforce two years after the 2020 assessment. This cross-sectional descriptive study used a convenience sample of pediatric APRNs affiliated with the National Association of Pediatric Nurse Practitioners (NAPNAP). A modified NAPNAP survey explored numerous impacts of COVID-19 on the pediatric APRN workforce. Study participants (n=1,087) reported widespread pandemic impacts across personal and professional domains. Alarmingly, 87% reported professional burnout, and 80% expressed concern over their overall mental health. The impacts of the pandemic on child health are ominous, with 94% of participants reporting pediatric mental health concerns, a devastating increase from the previous study. The pediatric APRN workforce is in crisis amid a national pediatric mental health emergency. Multilevel interventions are critically emergent to sustain the APRN workforce and promote the health and well-being of children and families.

I am Seen: Processing Grief as a Pediatric Oncology Nurse Practitioner.

Nurses and advanced practice providers are encouraged to embrace resilience skills to deal with compassion fatigue and prevent burnout. As a Christian nurse, I learned the importance of daily staying close to Jesus when a beloved pediatric oncology patient died and I experienced overwhelming grief. Through prayers, Bible reading, and honoring the patient with coworkers, I found hope in Jesus' presence. God sees me as his beloved child and gives me strength to continue my work.

Considerations for subspecialty preparation for nurse practitioners

The number of nurse practitioners (NP) entering pediatric gastroenterology is increasing. Most nurse practitioners acquire knowledge and skills through special NP fellowship programs and on-the-job training. However, professional competencies have yet to be defined or standardized. The authors sought to evaluate subspecialty nursing organizations' role in developing education programs that improve NP preparation for practice. Nurse Practitioners completed an assessment survey to determine the need for an education program and the type of education program desired. Based on the survey feedback, the authors created a pediatric gastroenterology-focused education program through the National Association of Pediatric Nurse Practitioners (NAPNAP) in partnership with the Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN). A pre-test/post-test design was utilized to determine knowledge obtainment. Post-test knowledge scores supported the program's ability to increase preparation. A post-test score increase was noted among new NPs and those who were members of specialty organizations. The development, implementation, and evaluation of standardized competencies and education programs through specialty organizations should be considered.

Pediatric Nurse Practitioner Knowledge of and Attitudes Toward Human Trafficking: A Psychometric Evaluation

Human trafficking is an urgent health threat. This study sought to psychometrically validate the novel Pediatric Nurse Practitioner Knowledge and Attitudes Toward Human Trafficking scale. Using data from a 2018 study of pediatric-focused advanced practice registered nurses (n=777), this secondary analysis examined dimensionality and reliability of the survey. The Cronbach α for scale constructs was < 0.7 for knowledge and 0.78 for attitudes. Exploratory and confirmatory analyses identified a bifactor model for knowledge with relative fit indexes within standard cutoffs, root mean square error of approximation=0.03, comparative fit index=0.95, Tucker-Lewis index=0.94, and standardized root mean square residual=0.06. The attitudes construct indicated a 2-factor model with root mean square error of approximation=0.04, comparative fit index=0.99, Tucker-Lewis index=0.98, and standardized root mean square residual=0.06, within standard cutoffs. The scale is a promising tool in advancing nursing response to trafficking but needs further refinement to increase utility and uptake.

Lactation Curricular Content of Pediatric Nurse Practitioner Programs in the United States: A National Survey

Lactation Curricular Content of Pediatric Nurse Practitioner Programs in the United States: A National Survey

Translation and validation of the PPSC-PNP instrument to measure parental satisfaction with care from pediatric nurses in China

PurposeTo modify and translate the Parents' Perceptions of Satisfaction with Care from Pediatric Nurse Practitioners instrument into Chinese, culturally adapt and initially test it to assess parental satisfaction with care from all levels of pediatric nurses in a pediatric inpatient care context. Design and methodsThe instrument was translated and culturally adapted following a standardized guideline for the translation and cross-cultural adaptation of self-report measures. Content validity, discriminative validity, internal consistency and test-retest reliability were examined. ResultsFour main issues were identified in the translation and cultural adaptation stage. Modifications were therefore made to the Chinese Parents' Perceptions of Satisfaction with Care from Pediatric Nurses instrument. The item-level content validity indexes for the Chinese instrument ranged between 0.83 and 1.0. The Cronbach's alpha coefficient was 0.95, and the intra-class correlation coefficient for test-retest reliability was 0.44. ConclusionThe Chinese Parents' Perceptions of Satisfaction with Care from Pediatric Nurses instrument has good content validity and internal consistency and can be considered a suitable clinical evaluation tool to measure parental satisfaction with care from pediatric nurses in pediatric inpatient settings in China. Practice implicationsThe instrument is anticipated to be useful in strategic planning for Chinese nurse managers responsible for patient safety and quality of care. Additionally, it has the potential to serve as a tool to enable international comparisons in parental satisfaction with care from pediatric nurses after further testing.

Advisory Committee on Immunization Practices Recommended Immunization Schedule for Children and Adolescents Aged 18 Years or Younger - United States, 2023.

At its October 2022 meeting, the Advisory Committee on Immunization Practices* (ACIP) approved the Recommended Child and Adolescent Immunization Schedule for Ages 18 Years or Younger, United States, 2023. The 2023 child and adolescent immunization schedule, available on the CDC immunization schedule website (https://www.cdc.gov/vaccines/schedules), summarizes ACIP recommendations, including several changes from the 2022 immunization schedule† on the cover page, tables, notes, and appendix. Health care providers are advised to use the tables, notes, and appendix together to determine recommended vaccinations for patient populations. This immunization schedule is recommended by ACIP (https://www.cdc.gov/vaccines/acip) and approved by CDC (https://www.cdc.gov), the American Academy of Pediatrics (https://www.aap.org), the American Academy of Family Physicians (https://www.aafp.org), the American College of Obstetricians and Gynecologists (http://www.acog.org), the American College of Nurse-Midwives (https://www.midwife.org), the American Academy of Physician Associates (https://www.aapa.org), and the National Association of Pediatric Nurse Practitioners (https://www.napnap.org).

Career Choices and Experiences in Role Transition: A Multistate Survey of Pediatric-Focused Hospital-Based Nurse Practitioners

We examined factors influencing pediatric hospital-based APPs' career decisions and described the transition to practice experiences. We conducted a cross-sectional, descriptive electronic survey using a novel instrument to examine APP career decisions and transition to practice experiences among APPs in four Southeastern children's hospitals. There were 158 respondents composed of family nurse practitioners (NPs) (30%), primary care pediatric NPs (24%), and acute care pediatric NPs (18%). APPs chose their career to further their education (46%) and because of interest in pediatrics (18%). Most APPs had experience in pediatrics on APP graduation and were well prepared for the role (47%) and to care for pediatric patients (56%). Nearly two-thirds of APPs had an orientation. Early exposure to pediatrics influenced APP career choices and increased career preparedness. Although most APPs had an orientation, future studies should assess the impact of orientation on patient, professional, and organizational outcomes.

Intimate Partner Violence and Children: Essentials for the Pediatric Nurse Practitioner

Intimate partner violence (IPV) is a public health problem of epidemic proportions. IPV often starts early in adolescence and continues throughout an individual's lifespan. IPV is defined as abuse or aggression occurring in the context of a romantic relationship that is perpetrated by a current or former partner. IPV victims often experience severe psychological trauma, physical injury, and even death. The direct recipient of the violence is often not the only individual impacted. Children are often peripheral victims of IPV. It is vital that pediatric health care providers, including pediatric nurse practitioners, recognize that IPV is indeed a pediatric health care crisis requiring strategies for both identification and intervention. This continuing education article will discuss IPV and its impact on children from conception to adolescence while exploring implications for practice.

50 Years Ago in TheJournalofPediatrics: Pediatric Nurse Practitioners: 50 Years of Partnering for Children's Health

Silver HK. A blueprint for pediatric health manpower for the 1970's: the 1972 George Armstrong Lecture. J Pediatr 1973;82:149-56. Dr Henry Silver's lecture to the Ambulatory Pediatric Association is as resonant today as it was 50 years ago. He noted that there was an inadequate supply of pediatric health care providers and recounted a few rejected solutions, such as shortening the medical school curriculum. The focus of his lecture, however, was emphasizing the importance of nurse practitioners (NPs) in providing care for children. The first NPs in the US graduated from Dr Silver's program in 1965 after 4 months of postnursing training. Dr Silver found that both pediatricians and parents were satisfied with care received from the NP when using a combined model: having a NP provide care with a physician available for consultation as needed. NPs showed the potential to provide quality health care in primary are settings, and Dr Silver proposed that their roles could be expanded into the community by providing care in school-based clinics. The role of the NP has continued to evolve, and training has become more intense since Dr Silver's “blueprint for pediatric health manpower” lecture. NPs can select a master's program that can be completed in 2-3 years and, for those interested in educational advancement, a post-master's doctoral program that can be completed in 2-3 years. They also have the option to select the primary care or acute care tracks. The primary care track focuses education within the primary care setting, specialty clinics, or in the community, whereas the acute care track focuses on the care of hospitalized patients. Today, NPs have a presence in a variety of settings fulfilling their roles in the “diagnosis and management of acute and chronic illness, health promotion, disease prevention, health education and counseling.”1American Association of Nurse PractitionersDiscussion Paper: Standards of Practice for Nurse Practitioners, 2019 update.https://storage.aanp.org/www/documents/advocacy/position-papers/StandardsOfPractice.pdfDate accessed: October 11, 2020Google Scholar NPs play critical roles partnering with pediatricians in the care of children in primary care offices, school-based health centers, neonatal intensive care units, as members of surgical teams, and many other areas. Dr Silver was prescient in his call for enhancing the care for children by partnering with NPs, yet the shortage of health care providers is likely to continue. By the year 2030, there is estimated to be 76.3 million children in the US, with a decreasing number of pediatricians and only 1025 pediatric NPs becoming licensed yearly.2Gigli K.H. Beauchesne M.A. Dirks M.S. Peck J.L. White Paper: Critical shortage of pediatric nurse practitioners predicted.J Pediatr Health Care. 2019; 33: 347-355Abstract Full Text Full Text PDF PubMed Scopus (13) Google Scholar It remains as important as ever for pediatricians and NPs to continue working together and encourage ongoing development of both workforces.

Evaluating the Practice of Pediatric Nurse Practitioners: Is It Time for Dual Primary and Acute Care Preparation?

This survey aimed to evaluate contemporary pediatric nurse practitioner (PNP) practice as it relates to the competencies of both the primary and acute care population focus and settings of practice to guide curriculum revisions. The design of the study was a cross-sectional survey of PNPs certified by the Pediatric Nursing Certification Board. There were 2,265 surveys completed. Regardless of the certification type, PNPs report providing care across settings and integrating the competencies of both the primary and acute care PNP into practice. This warrants further consideration by programs to prepare future PNPs for dual primary and acute care certification.

Genital Examination of the Prepubertal Female: Essentials for Pediatric Nurse Practitioners.

Genital Examination of the Prepubertal Female: Essentials for Pediatric Nurse Practitioners.

Parent Satisfaction With Pediatric Nurse Practitioner Care in Specialty Services.

This study examined parent satisfaction with care provided to their children by Pediatric Nurse Practitioners (PNPs) in specialty areas at a tertiary care pediatric hospital. A convenience sample of parents of children cared for by 19 PNPs in different specialty settings completed a confidential survey consisting of demographic information and the Parents' Perception of Satisfaction with Care from the Pediatric Nurse Practitioners Instrument (PPSC-PNP). Data were analyzed using SPSS (IBM, Armonk, NY). The overall PPSC-PNP mean score was 129.82/140. Mean subscale scores ranged from 27.15 to 28.51/30. The general satisfaction score showed a mean score of 18.31/20. No statistical difference was found in parental satisfaction when scores were analyzed by the child's age, parent participant, or patient setting. These findings indicate that parents are highly satisfied with the care their children receive from PNPs across various subspecialties regardless of the child's age and clinical setting.