Pediatric Nurses:Who are they and What do they do ?

A Profile of School Nurses and Certified Pediatric Nurses (CPNs®)

Janet S. Wyatt, PhD, RN, FAANPExecutive Director – IPN

Sandi Delack, MEd, RN, NCSNNASN Past President & IPN Board Member

Certified Pediatric Nurse (CPN®) Exam

Launched 1989Founding Leadership –

Donna Wong, PhD, RN, CPN

Total Certified Oct 2011 = 15,220

Definition of Pediatric Nursing

• Includes health promotion, acute & chronic illness management and health restoration of infants, children, adolescents & their families.

• Pediatric nurses practice in a variety of settings & roles such as direct caregiver, educator, consultant, advocate, or care coordinator.

• Pediatric nurses assess, analyze, plan & implement nursing interventions & evaluate outcomes.

PNCB’s 2008 Practice Analysis Study

• Practice Analysis - Largest research survey ever completed of practicing pediatric nurses – over 2800 respondents

• Respondents identified a total of 72 pediatric nursing knowledge competencies and tasks critical to pediatric nursing practice

• These competencies and tasks are reflected in the exam

Knowledge & Skills linked to pediatric nursing practice??

Total CPNs = 15,220

89%

CPNs by Highest Degree (n= 15,220) 66%

25%

9%

Dedicated , Experienced - CPN®s Certified an average of 6 yrs

(range 0-30 yrs)

With current employer = 13 yrs (range 0-49 yrs)

93% Plan to remain with current employer for next six months

Examples of Competencies/Tasks on the CPN Exam

Assessment• Assess physical status, growth and development • Assess nutritional status of child• Assess barriers to care• Assess & report signs of abuse and neglect

Health Promotion• Teach health promotion strategies to child/family

e.g. safety, infection control• Discuss environmental factors that influence health

Examples (cont.)Management•Monitor for patient responses and adverse reaction to medication•Manage pain•Identify and intervene when patient needs immediate care•Nursing procedures (e.g. physiological monitoring, F&E admin., med. admin.)

Top Five Illness Conditions

RespiratoryGastrointestinal

Infectious DiseaseNeurology

Emergency Trauma

CPN Exam Content Outline (cont.)

Professional RoleIncorporate evidence-based findings into practice

Participate in disaster preparedness

Recognize legal applications in clinical situations (e.g. assent)

2008 CPN ® Content Outline (150 questions)

Assessment (30% ) Physical – Growth and development Psychosocial/Family

Health Promotion (10%)Management (50%)

Illness Psychosocial/Behavioral Chronic Care/End of Life

Professional Role (10%)

Pediatric Nursing Scope and Standards of Practice. A collaborative document combining pediatric nursing Scope & Practice documents from the ANA, SPN and NAPNAP

Six Standards of Pediatric Nursing Practice ◊ Assessment ◊ Planning

◊ Diagnosis ◊ Implementation

◊ Outcomes Identification ◊ Evaluation

2008 Pediatric Nursing Scope and Standards

11 Standards of Professional Performance

2008 Pediatric Nursing Scope and Standards

◊ quality of practice ◊ education

◊ collegiality ◊ collaboration

◊ professional accountability ◊ ethics

◊ resource utilization ◊ leadership

◊ research ◊ advocacy

◊ professional practice evaluation

2008 – Published by ANA, NAPNAP and SPN

“School nursing is a specialized practice of professional nursing that advances the well being, academic success, and life-long achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self management, self advocacy, and learning.”

NASN Membership Survey Results (~15,000)

92% Caucasian 29% Nationally Certified (NCSN)14% > 36 years experience86% public schools

Education50% Bachelors

28% Masters

10% Associate

*3% are NPs

• Most work directly for public schools

• All work within public health.

NASN 2007 Membership Survey

National ratio of RN to students = 1:1151

27% HEALTH APPRAISAL

28% HEALTH PROBLEMS AND NURSING MANAGEMENT

20% HEALTH PROMOTION/DISEASE PREVENTION

10% SPECIAL HEALTH ISSUES

15% PROFESSIONAL ISSUES

National Board for Certification of School Nurses

250 test questions

Does your district/school use electronic student health records?

56% use electronic

health records (2009 NASN

Survey)

Potential New Knowledge/ Practice Competency

Emerging Issues Affecting School Nursing Practice

More school children are uninsured, underinsured and undocumented – public health departments depend on school health services for these children

Increasingly complex care is provided in schools to medically fragile children and children with chronic health issues - schools hiring RNs to serve specific (special needs) students due to regulatory requirements

Physical and psycho-social health status of children is confounded by new social and environmental threatsFragmented & underfunded school health resources

CPNAssessment (30% )

• Physical Assessment • Psychosocial and G & D

Health Promotion (10%)

Management (50%)• Illness• Psychosocial/Behavioral• Chronic Care/End of Life

Professional Role (10%)

NCSN 27% HEALTH APPRAISAL

28% HEALTH PROBLEMS AND NURSING MANAGEMENT

20% HEALTH PROMOTION/DISEASE PREVENTION

10% SPECIAL HEALTH ISSUES

15% PROFESSIONAL ISSUES

Is this content in Undergrad BSN/RN Education ?

Knowledge Expectations in Pediatric Nursing Practice

Are We Preparing Nurses For These Important Roles?

Thank You!

QUESTIONS?