The SPN Pediatric Nursing Excellence Model: Differentiating pediatrics.

The question of what makes an "excellent" pediatric nurse has been asked frequently by both pediatric and non-pediatric nurses for many years. Longevity in the practice setting, increased formal education in the care of children and families, positive satisfaction surveys post encounter, quantity of professional presentations and publications, and specialty certification are often listed when discussing pediatric nursing excellence. However, pediatric nursing excellence (PNE) is not well defined. Current recognition mechanisms such as clinical ladders, Magnet© and Pathways© programs, and Benner's stages of clinical competence are not specific for pediatric nursing practice. Once the characteristics of pediatric nursing excellence are determined, they can be used as the basis for identifying pediatric-specific quality indicators. In 2020, SPN initiated a project to define the construct of "pediatric nursing excellence". Two years later, SPN published its Pediatric Nursing Excellence Model, consisting of a visual depiction accompanied by definitions of 16 concepts that comprise the PNE Model. This article presents the five stages of the development process, the components of a model of pediatric nursing excellence, and the potential uses of such a model.

Prevalence of Batrachochytrium dendrobatidis in immature eastern hellbenders Cryptobranchus alleganiensis from North Carolina, USA.

Batrachochytrium dendrobatidis (Bd) has been detected in wild hellbender Cryptobranchus alleganiensis populations, with rare instances of chytridiomycosis and Bd-induced mortality. To date, Bd surveillance in hellbender populations has been disproportionately focused on adult age classes. A lingering question is whether Bd might contribute to hellbender declines through disproportionate negative effects on immature age classes. The objective of this study was to quantify Bd prevalence and load in immature hellbenders in western North Carolina, USA. We conducted field surveys during 2018 and 2019 and collected 88 skin swabs from 84 hellbenders spanning 3 age classes. Bd was detected on 11% of individuals, including 8 larvae and 1 juvenile. We did not detect symptoms of chytridiomycosis or a decline in body condition in Bd-positive hellbenders. Load varied from approximately 1-153 zoospore equivalents for the 9 Bd-positive hellbenders and was not associated with size class of the individual. While hellbenders appeared to be abundant in each survey reach, more work is needed to determine whether Bd may increase the vulnerability of immature hellbenders to anthropogenic stressors.