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.

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.

Evaluating Nurse Practitioner Student Competencies: Application of Entrustable Professional Activities.

BACKGROUND: A knowledge gap exists regarding the best methods for assessment of nurse practitioner (NP) student clinical competence. Entrustable professional activities (EPAs) translate competencies into practice and provide a potential framework for NP clinical competency assessment. This study piloted the use of an EPA-based method of assessing NP student clinical competence via simulated clinical experiences. METHOD: Six EPAs were mapped to NP core competencies. Faculty designed clinical scenarios to assess student clinical performance using EPA-based rubrics. Online family nurse practitioner students rotated through simulated clinical scenarios during an on-campus residency. Faculty assigned a utility score to each EPA activity description. RESULTS: Student EPA scores paralleled time-based program requirements. Faculty found over 70% of EPA activity descriptions to be useful or requiring minor editing in assessing students. CONCLUSION: This study is an important step toward the creation of a standardized, competency-based process for NP clinical performance assessment. [J Nurs Educ. 2020;59(12):714-720.].

A Job Task Analysis of the Expanding Role of the Pediatric Mental Health Specialist and the Nurse Practitioner in Pediatric Mental Health.

Lack of access to support, services, and providers for children and adolescents with mental health conditions is a serious problem in the United States. Fewer than half of the children who need services obtain them. To meet this demand, the Pediatric Nursing Certification Board launched a new specialty certification in 2011 for advanced practice registered nurses called the pediatric primary care mental health specialist (PMHS). In 2016, a job task analysis of the role of the PMHS and nurse practitioners practicing in pediatric mental health and developmental/behavioral pediatrics was conducted. Surveys were completed by 293 respondents. Demographic characteristics, tasks performed in practice, diagnoses made, assessment and screening tools used, and types of pharmacologic and nonpharmacologic interventions were obtained and are reported. The roles of the PMHS and nurse practitioner in pediatric mental health are well established and key to expanding services and access to children and their families.

SBIRT Education for Nurse Practitioner Students: Integration Into an MSN Program.

BACKGROUND: Substance use disorders are a major public health problem. As primary care providers, nurse practitioners (NPs) must be proficient at screening, identifying, and intervening for at-risk patients. Screening, brief intervention, and referral to treatment (SBIRT) is a well-established, evidence-based model for teaching behavioral health skills to health care providers. It is vital that Master of Science in Nursing (MSN)-NP programs incorporate SBIRT into their curricula. METHOD: SBIRT content was mapped to 10 courses across an MSN-NP program. Methods of integration included readings, lectures, case studies, role-plays, tutorials, symposia, and test questions, as well as tracking the use of SBIRT during clinical preceptorships. RESULTS: A total of 139 online and on-campus MSN-NP students were trained. Data demonstrate students successfully implemented SBIRT in precepted clinical settings. CONCLUSION: This approach provides a framework for integrating SBIRT training into MSN-NP curricula. [J Nurs Educ. 2017;56(12):725-732.].

Key considerations for moving to a nurse faculty role: A dean's perspective.

Expert nurse practitioners (NPs) grounded in clinical practice are needed to prepare the future NPs. This article discusses key considerations for moving from the role of expert clinician to nurse educator. The considerations for making the move to the educator role including reflection on rewards associated with teaching, similarities between practice and education, faculty support, and role responsibilities are presented from a dean's perspective. The typical hiring process is discussed including what questions may be asked of the faculty candidate as well as what questions should be asked by the faculty candidate.

Capacity of, and Demand for, Pediatric Nurse Practitioner Educational Programs: A Missing Piece of the Workforce Puzzle.

BACKGROUND: In contrast to family nurse practitioners and other adult nurse practitioners, the percentage of new pediatric nurse practitioners (PNPs) graduating each year has not increased. PURPOSE: The aim of this study was to determine whether the marginal increase in the pipeline for PNPs is related to a limit in the capacity of educational programs or whether unfilled student openings exist. METHODS: Self-administered survey of program directors at all recognized PNP educational programs in the United States. RESULTS: Approximately 10% of PNP programs in the United States were either closed, put on hold, or did not have new graduates in the last 3 years. Even with these closures, over 25% of active programs did not fill all available positions for the class entering in 2012. CONCLUSION: Despite evidence that demonstrates plans by employers to hire a greater number of PNPs in a variety of clinical venues including pediatric hospitals, primary care and subspecialty pediatric practices, the PNP pipeline has remained relatively stagnant. More than one third of program directors do not believe that their PNP program is currently at capacity, indicating that underutilized capacity to educate PNPs is a hindrance to meeting the current and future demands for these professionals.

Childcare health and health consultation curriculum: trends and future directions in nursing education.

PURPOSE: The purpose of this study was to identify graduate and undergraduate nursing courses in health and health consultation in childcare and early education, and faculty awareness and interest in federal resources. DESIGN AND METHODS: A questionnaire was sent electronically to 140 faculty in 45 schools of nursing. RESULTS: Fifty-nine faculty from 45 schools (42%) participated, and 80% reported at least one course related to childcare health and safety. Most faculty were not aware of federal initiatives to support childcare health and safety, and the role of nurse childcare health consultants; however, many were interested in receiving instructional materials. PRACTICE IMPLICATIONS: Utilizing federal resources to augment nursing education in childcare health and safety curriculum may strengthen the workforce of nurses providing health consultation to early childhood programs.

Improving health-care quality through an AFPNP National Nursing Education Collaborative to strengthen PNP curriculum in mental/behavioral health and EBP: lessons learned from academic faculty and clinical preceptors.

In 2004, the Association of Faculty of Pediatric Nurse Practitioners was awarded a grant by the Commonwealth Fund to plan, implement, and evaluate a strengthened national curriculum for students in 20 pediatric nurse practitioner programs throughout the United States. Curricular changes focused on increasing the knowledge and skills of students in the area of evidence-based mental and behavioral health care for children and adolescents. The processes through which this national initiative was undertaken were described in "Strengthening PNP Curricula in Mental/Behavioral Health and Evidence-Based Practice" (B. M. Melnyk et al., 2010). This article focuses on the important perspectives of academic faculty and clinical preceptors and provides critical insight for nursing faculty when planning implementation of significant curricular change. The purpose of this descriptive study was to determine the challenges and facilitators of implementing a strengthened curriculum in didactic and clinical courses to inform nationwide dissemination of this curriculum to all PNP programs throughout the country. Confidential, structured, individual telephone interviews were conducted with academic and clinical preceptors from the schools that had participated in the implementation study. Curricular change presents challenges in most schools of nursing and will be affected by characteristics unique to each institution. Faculty need to be educated regarding the factors that are likely to enhance the process of making important and timely changes in curriculum. Finally, valuable lessons regarding the necessary early engagement of clinical preceptors should inform future curricular change initiatives.

A national survey of the primary and acute care pediatric nurse practitioner educational preparation.

INTRODUCTION: The past decade has been marked by a gradual expansion of the traditional primary care role of the pediatric nurse practitioner (PNP) into practice arenas that call for more acute and critical care of children. The purpose of the study was to explore the educational programming needs of dual (combined) track PNP programs that prepare graduates to provide care to children and adolescents across the continuum of health and illness. METHOD: A two-phase, exploratory, mixed method design was utilized. An electronic survey was completed by 65% of PNP program directors in the country. Semi-structured telephone interviews were conducted with hospital-based PNPs who were practicing in roles that met a range of health care needs across the primary and acute care continuum. RESULTS: Primary care and acute care programs have more common than unique elements, and the vast majority of clinical competencies are common to both types of program. Only three competencies appear to be unique to acute care programs. DISCUSSION: The Association of Faculties of Pediatric Nurse Practitioner Programs should utilize existing evidence and develop guidelines for dual PNP programs that focus on the provision of care to children across a wide continuum of health and illness.

Strengthening PNP curricula in mental/behavioral health and evidence-based practice.

INTRODUCTION: The incidence of mental health/behavioral and developmental problems in children and teens is escalating. However, many primary care providers report inadequate skills to accurately screen, identify, and manage these problems using an evidence-based approach to care. Additionally, educational programs that prepare pediatric nurse practitioners (PNPs) have been slow to incorporate this content into their curriculums. METHODS: The purpose of this project was to implement and evaluate a strengthened curriculum in 20 PNP programs from across the United States that focused on: (a) health promotion strategies for optimal mental/behavioral health and developmental outcomes in children, and (b) screening and evidence-based interventions for these problems. An outcomes evaluation was conducted with faculty and graduating students from the participating programs along with faculty and students from 13 PNP programs who did not participate in the project. RESULTS: Participating schools varied in the speed at which components of the strengthened curriculum were incorporated into their programs. Over the course of the project, faculty from participating programs increased their own knowledge in the targeted areas and reported that their students were better prepared to assess and manage these problems using an evidence-based approach. Although reports of screening for certain problems were higher in the graduating students from the participating schools than the non-participating schools, the overall use of screening tools by students in clinical practice was low. DISCUSSION: There is a need for educational programs to strengthen their curricula and clinical experiences to prepare students to screen for, accurately identify, prevent, and provide early evidence-based interventions for children and teens with mental health/behavioral and developmental problems. This project can serve as a national model for curriculum change.

A national survey of PNP curricula: preparing pediatric nurse practitioners to meet the challenge in behavioral mental health.

The emergent mental health needs of children and adolescents have been declared a national priority by the Surgeon General of the United States (United States Department of Health and Human Services [USDHHS], 1999). Pediatric nurse practitioners (PNP) are called upon to respond to a new challenge by increasing their knowledge and skills in providing mental health care in the primary care setting. In turn, educators of PNP programs across the country are called upon to evaluate the status of PNP curricula in the field of behavioral/mental health and determine the essential competencies needed to meet the challenge. A survey was conducted to determine the extent of pediatric mental/behavioral health content currently taught in nationally approved PNP programs to discern the level of preparation PNP students received both in the classroom and clinically in the area of the assessment, diagnosis, and management of mental/behavioral health problems in children and adolescents. The final survey included a total of 78 nationally recognized PNP programs. Pediatric behavioral/mental health content was found to vary widely across programs, but it was apparent that all programs had begun to expand their curricula to include more content in this area. As the role of the PNP continues to expand, the burden of providing a sound education in a feasible time frame will be an increasing challenge.

Case study of a young man with tremor.

PURPOSE: To provide the clinician with an opportunity to review the most common causes of tremor in young adults. DATA SOURCES: Extensive review of international scientific literature on tremors and other movement disorders, supplemented by a recent case study. CONCLUSIONS: Essential tremor (ET) is the most common tremor disorder in the world. In contrast to common expectations, the 2nd decade of life represents a period of peak incidence. The early presentation may be so mild that the tremor goes unnoticed by patients and clinicians for many years. The most important movement disorder to rule out in the workup of patients with tremors is Parkinson's disease. IMPLICATIONS FOR PRACTICE: The diagnosis of ET is generally made on clinical grounds. A comprehensive history and careful physical examination that rules out cerebellar or extrapyramidal disease is required. The clinician must distinguish between resting tremors and action tremors. If the appropriate diagnosis is unclear, a tremor recording (electromyogram) may assist in this distinction. Referral to a neurologist may be warranted.