Elizabeth Hawkins-Walsh

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 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.

Emerging Issues Regarding Pediatric Nurse Practitioner Education in Acute and Primary Care

The climate of health care in the United States continues to be tumultuous, with widespread calls for change. Concerns about health care costs are matched by public demands for quality, safety, efficiency, and appropriate access for all (Institute Of Medicine [IOM], 2001; Sorian, 2006). Nurse practitioners (NPs) are increasingly recognized as providing a level of care comparable to physicians (Brooks, 2009), prompting the design of newmodels of care delivery that integrate NPs. This growing recognitionofeffectivenesshasgiven rise to a myriad of new NP positions in diverse settings ranging from community-based to high-acuity critical care. Nursing educators are challenged to effectively deliver NP educational programs to meet the demand for highly skilled advanced practice registered nurses (APRNs). Recent landmark collaboration between theNational Council of State Board of Nursing (NCSBN) and the APRN Joint Dialogue Group has resulted in the widely supported document, ‘‘Consensus Model for APRN Regulation: Legislation, Accreditation, Certification, and Education’’ (NCSBN, 2008). This publication establishes common language around titles, scopes of practice, and patient populations; it clarifies terminology, regulation, and roles of all types of APRNs, including primary care and acute care NPs. The consensus document lays the groundwork to create a consistent approach to APRN credentialing by logically linking the

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

BACKGROUND Studies have demonstrated a dramatic increase in the number of new nurse practitioners (NPs) overall completing NP education each year. However, NPs who provide specialized care to children have not experienced increases in their pipeline at all. This has resulted in shortages of neonatal nurse practitioners (NNPs). PURPOSE The aim of this study was to gain a greater understanding of the NNP pipeline and potential for increasing the number of new NNPs graduating each year. METHODS Telephone survey of all NNP educational programs. DISCUSSION Approximately one fourth of all NNP education programs had closed over the past several years. This is despite a strong job market, planned increases in hiring NNPs, and a seemingly growing shortage of NNPs. CONCLUSION Problems with the NNP pipeline are not due to a lack of capacity of existing programs, but rather to difficulties in increasing the enrollment demand.

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.

Guidelines for Dual Certification in Acute-Care and Primary-Care Pediatric Nurse Practitioner Programs☆

In increasing numbers, pediatric nurse practitioner (PNP) students seek educational programs that prepare them for dual certification in acute care and primary care. In 2008, an AFPNP research team of faculty experts was convened to examine areas of commonality and distinction between acute-care and primary-care PNP programs. This team surveyed all acute-care and primary-care PNP programs in the country and conducted interviews with hospital-based PNPs who were practicing in roles that met a range of health-care needs across the acute-care and primary-care continuum. Based on the results of the survey and interviews, an AFPNP task force created guidelines for combined educational programs that prepare students for dual certification as acute-care and primary-care PNPs.

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 Parkinsons 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 (elec‐tromyogram) may assist in this distinction. Referral to a neurologist may be warranted.

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

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 deans 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.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 deans 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.

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 deans 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.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 deans 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.