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

BACKGROUND: Educational 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. METHODS: A 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. DISCUSSION: This 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.

Best Practices for Depression Screening Among College Students: A Literature Review.

Rates of depression among the college-aged population are alarming, particularly in light of the coronavirus disease 2019 pandemic. It is important for providers who care for this population to have proper screening and referral processes to meet growing student needs. The purpose of this literature review was to examine current best practices for depression screening among college students. Comprehensive searches of PubMed, CINAHL, Embase, and Cochrane databases were completed with the assistance of a medical librarian. A total of 775 studies were screened, and 17 articles were included in the review. Evidence supports universal-based depression screenings; use of screening methods to include brief and online screenings; use of validated screening tools, including the Patient Health Questionnaire (PHQ) -2 and PHQ-9; and the importance of a proper referral process and adequate access to treatment measures. An appropriate depression screening and referral process within campus health centers is critical to meet the needs of college students. [Journal of Psychosocial Nursing and Mental Health Services, xx(x), xx-xx.].

Establishing the doctor of nursing practice project ethical review process to improve standardization, efficiency, and timeliness.

BACKGROUND: DNP Scholarly projects require review for scientific merit and human subject protection. Rapid growth of DNP programs and projects has increased Institutional Review Board (IRB) burden and increased the length of project approval time when most DNP scholarly projects are quality improvement (QI) projects and not deemed Human Subjects Research (HSR). PURPOSE: Develop a process and describe the rationale for creating and implementing a Project Ethical Review Committee (PERC) in the School of Nursing and to evaluate the experience of the first cohort of submissions. PROCESS: Committee was formed using expert consensus approach, in collaboration with IRB. Standards of Procedures and training materials created. OUTCOME MEASURE: 100 projects submitted to committee; 95 deemed QI (95%) and 5 projects considered HSR (5%). First 94 projects were reviewed, and approval letters sent within 8 weeks. DISCUSSION: This paper discusses how PERC ensures rigorous and ethical review process for standardization, timeliness, and efficiency.

An Integrative Review Regarding Knowledge and Self-Competency of Pediatric and Neonatal Critical Care Transport Nurses.

OBJECTIVE: As the health care setting has become more centralized, there has been an increased need for critically ill neonatal and pediatric patients to be transported to facilities for a higher level of care. These interfacility transports are possible through the utilization of highly specialized teams of health care providers. Unfortunately, there is currently a lack of consistency in training these teams to provide safe care. The purpose of this integrative review was to identify the best practice for improving nursing knowledge and self-competency in critical care neonatal and pediatric interhospital transport. METHODS: A literature search was conducted to answer the following question: What are the best practices to improve/assess nursing knowledge and self-competency in critical care neonatal and pediatric interhospital transport? The articles found were then appraised using the Johns Hopkins Evidence-Based Practice Model's appraisal tool. RESULTS: Eight articles were included in the final review and found to be of good quality. From these articles, 4 themes were identified that address the best practices in the education of critical care transport nurses: increased knowledge and skills with simulation, improved self-efficacy and satisfaction of nurses with simulation, knowledge assessment is feasible through tests and checklists, and the importance of debriefing among nurses with simulation. CONCLUSION: The incorporation of routine simulations that include knowledge tests, checklists, and targeted educational debriefings for interhospital neonatal and pediatric critical care transport teams improves and verifies nursing knowledge and self-competency. Future research should focus on the design and curriculum specifications of this educational plan within critical care interhospital transport.

Breastfeeding Plan of Care for the Late Preterm Infant From Birth Through Discharge.

The focus of this clinical practice case is on the initiation of successful breastfeeding in the late preterm infant. The exploration of a case of a late preterm infant born at 360/7 weeks' gestation, delivered via cesarean section, at risk for breastfeeding challenges. Common difficulties encountered in the late preterm, defined as 340/7 to 366/7 weeks' gestation, include delayed lactogenesis, decreased milk transfer, and ineffective suck and swallow. This may lead to hospital readmission due to inadequate weight gain, dehydration, and/or hyperbilirubinemia. These difficulties often result in premature breastfeeding cessation. A management strategy incorporating an individualized mother's breastfeeding plan of care across 2 care continuums is a unique feature in this case presentation. Assessment of the mother-infant dyad provides the foundation to develop clinical strategies to initiate prompt individualized lactation support for the late preterm infant. Interventions focus on establishing maternal milk supply, facilitating milk transfer, and providing breast milk to the newborn. This case illustrates how developing an individualized in-hospital breastfeeding plan for the late preterm infant, followed by comprehensive primary care follow-up at discharge, can reduce the risk factors that lead to readmission in the late preterm birth and promote breastfeeding success.

Innovative Simulation Roadmap for Faculty to Prepare Advanced Practice Registered Nurses for Entry Into Practice.

ABSTRACT: Advanced practice registered nurse (APRN) programs are challenged to provide clinical learning experiences that prepare graduates with the full continuum of expected competencies. Preparing the APRN in academia, in terms of didactic and clinical application for novice entry, is often a vexing balance between board certification preparedness and the actualities of clinical practice. This article presents an innovative strategy to examine the perplexing reflective question often asked by educators: Does the current approach for simulation development prepare our APRN students sufficiently for entry into practice, and is it current to what is occurring in practice?

An Integrative Review of Family Health History in Pediatrics.

The aim of this integrative review is to investigate current literature regarding family health history (FHH) taking practices, attitudes, and challenges in the pediatric outpatient setting. FHH is a known clinical tool for providers; however, there are no explicit standards for pediatric FHH collection. The integrative review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. PubMed, Embase, CINAHL, PsycINFO, and Cochrane databases were searched for publications between January 2010 and December 2019, and 8 articles were selected for evaluation. Three themes are explored in this review: FHH collection practices, challenges, and tools. FHH collection practices were found to be inconsistent and the most commonly cited challenge was time. No validated FHH collection tools have been identified for the pediatric population. These findings suggest the need for standardization in FHH collection and further development of tools to improve FHH collection.

Clinical Management of the Breast-Feeding Mother-Infant Dyad in Recovery From Opioid Dependence.

Human milk is one of the most health-promoting and cost-effective nutritional substances known to humankind. Breastmilk provides substantial and remarkable physiological and psychological health benefits. Within the last decade, there has been a resurgence of breast-feeding in the United States and worldwide and an increased awareness of the immense health benefits for mothers, infants, and societies that support it. Each mother-baby dyad is a unique pair, with distinct relationships, biases, barriers, and obstacles. This article aims to address clinical management for the opioid-recovering breast-feeding dyad and to translate current evidenced-based practice findings, recommendations, and resources to best support this unique population. The recovering breast-feeding mother and newborn with opioid dependence deserve special consideration and expert care to foster their recovery and breast-feeding efforts. It is our moral and ethical responsibility as healthcare professionals to enable, foster, and promote breast-feeding among all families, especially those who stand to benefit the greatest. Substance recovery cannot be treated in isolation, nor can breast-feeding efforts; an interdisciplinary professional team effort promises the greatest chances for recovery success. With appropriate evidence-based practice support, training, and intervention by knowledgeable professionals, many women can overcome the biases and obstacles associated with opioid recovery to successfully breast-feed their babies.

Clinical practice breastfeeding recommendations for primary care: applying a tri-core breastfeeding conceptual model.

Promotional practice efforts are needed in primary care to support and foster breastfeeding as the first and natural choice of nutrition for all infants regardless of race, ethnicity, educational, or income demographics in the United States. Societal awareness is increasing with regard to the significant protective qualities that human milk bestows upon public health. An estimated 75% of American mothers attempt to breastfeed, but according to the Centers for Disease Control and Prevention, just 13% are able to exclusively breastfeed by 6 months. Early identification of lactation issues is crucial to establishing and sustaining breastfeeding for the first 6 to 12 months of the child's life and beyond. We propose a set of primary care guidelines, applying a Tri-Core Model approach, to promote and foster breastfeeding efforts in the postpartum period. Breastfeeding promotion is a fundamental public health endeavor, and pediatric nurse practitioners and other advanced practice registered nurses (APRNs) are uniquely qualified to become specialists and experts in lactation care and management. Lactation support, which should be an integral facet of an APRN's practice and education, will aid in improving national breastfeeding rates and patient care outcomes. Application of the Tri-Core Model approach will help APRNs develop and implement evidence-based practice efforts that incorporate the mother-baby dyad and other multiprofessionals who are vested in successful breastfeeding outcomes. The goal of pediatric health care is provide safe and effective health care to all infants, children, and adolescents, and lactation care is an integral and crucial component of this effort.