Michelle A. Beauchesne

Advanced practice nursing: a concept analysis.

A variety of terms are used to describe advanced practice nursing roles internationally. This has resulted in confusion in terminology around these roles. The aim of this concept analysis was to clarify what is meant by advanced practice nursing internationally, what attributes signify advanced practice nursing and what are its antecedents, consequences, references and related terms. Rodgerss evolutionary method of concept analysis was used. Data sources included Medline, CINAHL, Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Library, Science Direct, SCOPUS, Web of Science, Dissertation Abstracts and DARE as well as relevant nursing texts and professional organization websites. The analysis reveals that there are many different articulations of the advanced practice nursing role outlined in the literature. This variety in terminology hinders developments in advanced practice nursing roles. Consensus on advanced practice nursing definitions, terminology, educational requirements and regulatory approaches is integral to the implementation of the advanced practice nursing role internationally.A variety of terms are used to describe advanced practice nursing roles internationally. This has resulted in confusion in terminology around these roles. The aim of this concept analysis was to clarify what is meant by advanced practice nursing internationally, what attributes signify advanced practice nursing and what are its antecedents, consequences, references and related terms. Rodgerss evolutionary method of concept analysis was used. Data sources included Medline, CINAHL, Applied Social Sciences Index and Abstracts (ASSIA), Cochrane Library, Science Direct, SCOPUS, Web of Science, Dissertation Abstracts and DARE as well as relevant nursing texts and professional organization websites. The analysis reveals that there are many different articulations of the advanced practice nursing role outlined in the literature. This variety in terminology hinders developments in advanced practice nursing roles. Consensus on advanced practice nursing definitions, terminology, educational requirements and regulatory approaches is integral to the implementation of the advanced practice nursing role internationally.

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.

An interdisciplinary community-based educational model

The purpose of this article is to describe an innovative partnership among academic, community, and service to better meet the health care needs of underserved populations. The Center for Community Health Education, Research, and Service--a coalition of Boston education institutions, health services providers, and community agencies--was formed with a grant from the W. K. Kellogg Foundation. The initial goal was to establish academic community health centers comparable to the large teaching hospitals that combine service, education, and research as the corner-stone of their mission. With faculty based in the neighborhood health centers, students have learning opportunities to assess, plan care, and treat individuals and families using a community-based primary care model. The nature of the partnership, including the structure and process of implementation, is described. The developmental socialization of advanced practice nursing students in a community based-setting is discussed. Educational and service outcomes are identified.

Children with Disabilities Need a Head Start Too

Recently, the US Head Start program has been expanded to Early Head Start, which targets pregnant women and children under 3 years. Head Start is mandated to enroll children with disabilities as at least 10 percent of their population, and such children comprise approximately 13 percent of the programs in Massachusetts. However, the majority of these children have speech and language problems; less than 1 percent are diagnosed with more severe or complex disorders. To further clarify service patterns, a mail survey was conducted with directors of Head Start programs in New England. Fifty surveys were completed and analyzed. The results are consistent with previous findings that Head Start is underused as a service for children with more than mild disabilities. Specific issues are discussed and recommendations made.

Violence prevention: a community approach.

Violence among children and adolescents has been elevated to the status of a public health problem in the United States today. Pediatric nurse practitioners are in a unique position to play a major role in violence prevention. This article describes the impact of violence on the preschool child including developmental and behavioral issues. Violence prevention must be all-inclusive as a routine component of anticipatory guidance for preschool children and their families. Ways to integrate violence prevention into a primary care approach are addressed. Community-based outreach programs that further buffer the impact of violence on these children are discussed.

Reflections on T. Berry Brazelton, MD's influence on pediatric nursing

PURPOSE The purpose of this article is to provide examples of Dr. Brazeltons important influence on pediatric nursing, and by extension, the work of child psychiatric mental health nurses, the care of children and families, and ultimately, the healthcare delivery system. SOURCES Dr. Brazeltons professional colleagues, research, professional journals, and books. CONCLUSION Over the past 40 years, T. Berry Brazelton has had a major impact on the development of pediatric nursing, infant mental health, and the nurse practitioner movement. He has influenced the growth and development of nursing organizations, nursing education, nursing research, nursing practice, and health policy affecting nurses.Purpose The purpose of this article is to provide examples of Dr. Brazeltons important influence on pediatric nursing, and by extension, the work of child psychiatric mental health nurses, the care of children and families, and ultimately, the healthcare delivery system. Sources Dr. Brazeltons professional colleagues, research, professional journals, and books. Conclusion Over the past 40 years, T. Berry Brazelton has had a major impact on the development of pediatric nursing, infant mental health, and the nurse practitioner movement. He has influenced the growth and development of nursing organizations, nursing education, nursing research, nursing practice, and health policy affecting nurses.

Genetics is Advancing on us! Where Do We Go from Here?

A recent editorial in this journal addressed the explosion of knowledge in genetics and implored all health professionals to engage in the process (Barr, ). I endorse that advice emphatically. Genetics is not only the future, it is the present. Health professionals need to acknowledge that genetic science is not just for specialists but for generalists as well. Just as every heart murmur need not be referred to a cardiologist, no longer will every genetic issue be referred to a geneticist! Clinicians caring for individuals with learning disabilities need to be well versed in both the science and art of genetics. Many health professionals still deny the need to integrate genetics into their practices (Dumont-Driscoll, ). However, all clinicians face the challenge to identify individuals who may benefit from genetic services; screen those individuals and families who may be at risk for developing genetic disorders; and efficiently access information on resources, referrals, availability of diagnostic testing and interpretation of findings. It is not easy to remain on the cutting edge of health care when that edge keeps getting farther away. In an age of instant communication consumers expect instant answers and information about their health. How do we as experts in learning disabilities keep abreast of the rapidly expanding field? The answer may be to adopt a two-tiered approach to solving the problem. First, health professionals need to be informed and current. The first step would be to assist clinicians maintain their expertise. Strategies must include acquiring new knowledge, developing new skills, and changing attitudes about genetics. Most important we need to improve accessibility of new knowledge. The second tier would address the need to better prepare future generations of clinicians. Genetics must become a significant part of any health profession curriculum. Emerging clinicians must be socialized into a different way of viewing health care issues through a genetic lens.        

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.

Buddies Not Bullies: an approach to bullying prevention education in preschool children, their families and the community

Bullying is a traumatic event and has been observed among children as young as four years old. We have designed the Buddies Not Bullies initiative, which is a series of projects to help preschool children protect themselves from bullying. We also designed projects to educate the families of these preschool children and their community on the effects of bullying. The Buddies Not Bullies initiative promotes social-emotional development and discourages behaviours that might lead to bullying. In this article the initiatives designed to engage preschool children and raise awareness, including an interactive puppet show, are outlined. The authors also discuss how they evaluated the success of these projects and the implications for all professionals caring for young children.

Ring in a safe and quality new year

I have always found the New Year to be a time for reflection and remembrance. Perhaps it is my Scottish ancestry reminding me that Hogamany is the traditional Scottish celebration of friendship and renewal every New Year’s Eve. The Scottish poet Robert Burns wrote the traditional poem, Auld Lang Syne in 1788, which literally translates ‘‘old long since’’ and has become a major part of New Year’s celebrations around the world (Burns, 2001). This is the season for acknowledging accomplishments and contemplating things left undone. This year is no different. So in that tradition it seems appropriate to review the goals and strategic direction for the future of the National Association of Pediatric Nurse Practitioners (NAPNAP) as we make our old-fashioned New Year’s resolutions. Foremost in NAPNAP’s strategic direction is improving the quality of children’s health by enhancing access to information through leadership, practice, advocacy, education, and research. This goal is achieved by disseminating standards of care, clinical guidelines, the latest research, and national safety standards; bypromotingprofessional andpublic education; and through networking. The year 2009 saw an unprecedented flurry of health care issues pertaining to this goal, many of which I have written about in earlier messages. Health care reform is not just legislation to be passed but also a mantra for changing a health care system that is flawed. Although you read this message in January, I write in early September when the future of health care reform is uncertain. Perhaps it is still uncertain. However, what is certain is that we need a health