Journal of Pediatric Health Care最新文献

Introduction: A Pediatric Nurse Practitioner (PNP) Competency Framework was developed and validated to describe how PNP competence progresses across a career, informing professional development and recertification.

Methods: The initial framework was created by a task force of subject matter expert PNPs and further refined through focus groups. Validation occurred via a national survey administered February-March 2023, with descriptive statistics used to analyze responses.

Results: The survey achieved a 7.4% response rate, with respondent demographics consistent with the PNCB demographic report from the same period. Over 95% of respondents agreed the framework accurately represented the PNP role.

Discussion: The validated framework emphasizes progression of behaviors across seven role-based competency domains: Clinician, Collaborator, Advocate, Educator, Scholar, Leader, and Innovator. It has implications for individual PNPs, healthcare organizations and employers, the national certification board, and other key stakeholders. The framework supports reflection on competence, career progression, goal setting, and workforce sustainability.

Introduction: Novice advanced practice nurses (APNs) and physician assistants (PAs), commonly referred to as Advanced Practice Providers (APPs), often feel unprepared for practice. Post-graduate APP training relies on internal clinicians and is variable due to the bandwidth of the training clinicians, and the preceptor's lack of knowledge or competency.

Method: Evaluation of a 12-month pediatric centralized APP fellowship program within an academic healthcare organization included pre-/post-program surveys, engagement scores, retention rates, and time to productivity for APP fellows compared to historical onboarding.

Results: Engagement scores rose from 3.86 to 4.15, internal transfer rates declined from 17% to 9%, turnover dropped from 8.2% to 3.8% and APP fellows reached productivity 4.2 months earlier than non-fellow hires.

Discussion: A centralized APP fellowship enhances engagement and retention while decreasing organizational costs. Understanding the return on investment (ROI) of post-graduate APP fellowships supports the need for these programs to strengthen workforce readiness.

Nursing implications: Post-graduate APP training is of critical importance, particularly as pediatric subspecialty patients become more complex, and historical training has been situated in matrixed specialty silos. Due to the lack of federal funding, implementation of a centralized transition to practice training within organizations safely builds standard competencies and essential organizational networks while decreasing turnover rates resulting in significant cost savings for healthcare organizations. To ensure long term sustainability of these training programs, understanding organizational ROI is essential.

Background: Podcasts are a popular educational tool in health professions that appeal to learners for their accessibility and flexibility. Skeptics criticize podcasts for issues related to quality and credibility, despite established quality criteria.

Methods: A podcast guideline was developed using a rapid review of the literature. Selected articles underwent synthesis and analysis. From these, key areas and recommendations were developed.

Results: Forty-eight articles informed the narrative synthesis that revealed 6 areas. Recommendations for areas included directives for 3 pertinent audiences: podcast producers, educators, and listeners and learners.

Discussion: High-quality podcasts are especially important to advocate for best practices in pediatric healthcare. The podcast guideline outlines evidence-based standards to guide podcast production and use for competency-based education for learner-centered outcomes. More research is needed to understand how podcast listening affects clinical outcomes. There is potential for artificial intelligence to advance podcasts, but it should be used cautiously and ethically.

This article addresses the gap in nonclinical professional skills that directly impact job satisfaction, retention, and career advancement for nurse practitioners. Despite the rapid growth of nurse practitioner roles, many nurse practitioners enter practice without adequate preparation for navigating organizational structures, negotiating contracts, and establishing a strong professional identity. These deficits contribute to high turnover rates, organizational costs, and provider burnout, issues that are particularly relevant in today's evolving health care landscape. This article introduces personal branding as a strategic, evidence-based approach to empower nurse practitioners to define their value, advocate for themselves, and foster long-term career success.

Introduction: The COVID-19 pandemic profoundly disrupted the pediatric advanced practice provider (APP) workforce, intensifying stressors, and highlighting the importance of work environments that support APP wellbeing and role satisfaction.

Purpose: This study aimed to describe pediatric APPs' organizational climate, structural empowerment, and psychological empowerment, and examine organizational commitment.

Methods: A descriptive cross-sectional survey was conducted among APPs at three Midwestern pediatric health systems. Validated instruments measured organizational climate (NP-PCOCQ), structural empowerment (CWEQ-II), and psychological empowerment (Spreitzer Scale).

Results: Among 145 respondents, mean scores indicated high professional visibility, physician relations, and independent practice, but lower administrative relations. APPs identified a lack of formal power, information, and support. APPs reported strong role meaning but lack of perceived impact. There were high levels of organizational commitment.

Conclusion: There is a need to promote administrative relationships, APP leadership roles, and policies that recognize APP contributions to health systems and patient outcomes.

Artificial intelligence (AI) is rapidly transforming pediatric healthcare, yet many pediatric nurse practitioners lack adequate preparation for implementation. This article provides foundational AI literacy while examining urgent needs for comprehensive policy frameworks, collaborative governance, and meaningful patient engagement in training data decisions. AI literacy must precede widespread implementation: practitioners, policymakers, and patients must understand how generative AI models work, how training data shapes outcomes, and ramifications of algorithmic bias. Drawing on recent literature, this discussion addresses practical clinical considerations and the critical advocacy role PNPs must play in shaping equitable, transparent, and accountable AI systems in healthcare.

Launching practice requires a detailed strategy which incorporates all aspects of practice ownership. Practice ownership allows the independent spirit to establish a practice in which one's philosophy of patient care, independent decision making, and return on investment gives the owner a sense of accomplishment. But it also has its drawbacks. The practice owner is responsible for all aspects of the business. This includes financial security, legal issues, income, patient billing, staffing, buying immunizations, malpractice insurance, office site management, and more.

Nursing professionals and doctoral nursing students engage in scholarly work throughout the academic experience and their careers. However, they often find the writing and publishing processes challenging. Studies have shown that 41.3% of Doctor of Philosophy (PhD) graduates who completed the traditional Doctor of Philosophy (PhD) dissertation never published the findings. To date, studies that have examined or validated the total number of Doctor of Nursing Practice graduates who have published their scholarly quality improvement or evidence-based practice improvement projects are limited. This article presents successful ways to organize and prepare a manuscript for submission to a nursing scientific journal. A discussion on editor decisions and ways to respond to reviewer comments and editor decisions is presented. Also discussed are unethical behaviors in scholarly writing including the problems and outcomes for authors who submit plagiarized work, duplicate submissions, using generative artificial intelligence to create a manuscript, and retractions of published work.

Clinical practice ladders are implemented to recognize and celebrate the professional achievements of nurse practitioners (NPs). An online survey about the NP clinical ladder (NP CL) applicants at a large quaternary care academic health system was developed to determine reasons for participation and associated recognition experienced by NPs who had successfully achieved placement on the ladder. All NPs in the health system who were successful in placement on the NP CL were included in the survey, which included pediatric nurse practitioners and family nurse practitioners. Results of this survey demonstrate lessons learned regarding the importance of recognizing professional achievements of NPs and provide critical insight for health system leaders when establishing and maintaining NP CL programs.

Introduction: Pediatric primary care access in the United States is hindered by pediatrician shortages, particularly in underserved and rural areas. Nurse practitioners (NPs), especially pediatric NPs, play an essential role to meet the demand for care in pediatric populations. However, little is known about how full practice authority (FPA) for NPs affects pediatric care experiences.

Methods: Using restricted-access Medical Expenditure Panel Survey data (2010-2019), we conducted ordinal logistic regressions under a difference-in-differences framework, where we observe outcomes in places with and without the policy intervention in the time periods before and after the policy change to elicit how much of the outcome change is driven by the policy. Outcomes included parent- and provider-reported measures of pediatric care. Models included FPA status, analysis of the years after the policy change, rurality, and the overall outcomes change when accounting for year and state.

Results: FPA implementation was associated with significant improvements in perceived time with providers and parental respect during visits. The percentage change in outcomes was smaller in rural areas.

Discussion/conclusion: FPA may enhance pediatric care experiences, particularly in non-rural areas. Targeted investments in rural infrastructure and further pediatric-specific evaluations are needed to optimize the impact of scope-of-practice reform.