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Section Editors: Mark D. Weber RN, CPNP (email: mark.weber2@duke.edu) and Judy Verger RN, PhD, CRNP (email: jtv@nursing.upenn.edu)

Advanced Practice Nursing in Pediatric Critical Care

The classic pediatric critical care nursing textbook : Critical Care Nursing of Infants and Children. 2nd Edition. Curley MAQ, Moloney-Harmon PA, eds. 2001. (this edition is out of print and now freely available)

Nursing Research Section in the EB Journal Club on PedsCCM

The PedsCCM Evidence Based Journal Club now has a Nursing Research section. The new section will highlight the research of Advanced Practice Nurses. APN's are encouraged to submit reviews to this new section.

To view trials awaiting review in Nursing Research, go to the Trials Awaiting Review page, select the Article Type "Nursing Research" and click search; a list of Nursing Research trials awaiting review is generated.

The Role of the Advanced Practice Nurse in the Pediatric ICU

M.J. Grant, P. Moloney-Harmon, S. Irving, T. Andrade, J. Verger

Advanced Practice Nurses (APN) are functioning as Nurse Practitioners (NP) and Clinical Nurse Specialists (CNS) in Pediatric Intensive Care Units (PICU) throughout the country. These individuals are expert nurses with a strong foundation and dedication to pediatric critical care. They are comfortable with the PICU environment and skilled at coordination of services.

The responsibilities of many pediatric critical care APN's represent a continuum, inclusive of the responsibilities of the traditional CNS and the emerging role of the PICU NP. The classic role of PICU CNS influences practice through staff education, practice, consultation, research, research dissemination and administration. . In the ICU, NP's with attending physician collaboration perform history and physical examinations, evaluate clinical data, provide standardization of care by reducing fragmented care and perform invasive procedures. Pediatric critical care APN's are employed in practice groups with other APN's or as the only APN member of the management team. APN's work in teaching and community hospitals and provide coverage in the PICU, as well as, other areas of the hospital and community.

Definition of the Acute Care PNP (2004):

Developed by a national panel of expert AC PNP educators, clinicians and policymakers

The CPNP Acute Care role is designed to meet the specialized physiologic and psychological needs of children with complex acute and chronic health conditions. AC-PNPs respond to rapidly changing clinical conditions, including the recognition and management of emerging health crises, organ dysfunction and failure. In accordance with this practice focus, CPNP-AC role activities encompass a wide range of NP practice strategies including contributions to the management of childrens' illness/health states, the client-nurses relationship, the teaching-coaching function, the professional role, managing and negotiating healthcare delivery systems, monitoring and ensuring the quality of health care practice, providing family-centered care, and demonstrating cultural competency. The short-term goal of care is stabilization of the child, minimizing complications, and providing physical and psychological care measures. The long-term goal of care is to resotre maximal health potential through implementation of NP strategies to reduce health risks. The continuum of care spans the geographic settings of the home, emergency departments, hospitals, sub-specialty clinics, and intensive care units. (referenced on: http://www.pncb.org/ptistore/control/exams/ac/index )

Literature on APNs in the PICU & Acute Care

    • Verger, JT; Marcoux KK, T; Madden, M; Bojko, T; Barnsteiner, JH. Nurse practitioners in pediatric critical care: results of a national survey. AACN Clin Issues. 2005 Jul-Sep;16(3):396-408. [abstract]
    • Molitor-Kirsch, S.; Thompson, L.; Milonovich, L. The Changing Face of Critical Care Medicine: Nurse Practitioners in the Pediatric Intensive Care Unit. AACN Clinical Issues: Advanced Practice in Acute & Critical Care. 16(2):172-177, April/June 2005.
    • Hoffman, L.A., Happ, M.B., Scharfenberg, C., DiVigilio-Thomas, D., Tasota, F.J. Perceptions of physicians, nurses, and respiratory therapists about the role of acute care nurse practitioners. American Journal of Critical Care 2004; 13(6): 480-488. (available as electronic copy online for AACN members)
    • Verger, J., Trimarchi, T., & Barnsteiner, J. H. Challenges of advanced practice nursing in pediatric acute and critical care: education to practice. Critical Care Nursing Clinics of North America 2002; 14, 315-326.
    • Derengowski SL, Irving SY, Koogle PV, Englander RM. Defining the role of the pediatric critical care nurse practitioner in a tertiary care center. Crit Care Med. 2000;28(7):2626-30. [abstract]
    • Martin SA. The pediatric critical care nurse practitioner: evolution and impact. Pediatric Nursing 1999, Sep-Oct; 25(5): 505-10. [abstract]
    • Delametter GL. Advanced practice nursing and the role of the pediatric critical care nurse practitioner. Crit Care Nurse Quarterly - 01-Feb-1999; 21(4): 16-21. [abstract]
    • Morse CJ, Brown MM. Collaborative practice in the acute care setting. Crit Care Nurs Q. 1999 Feb;21(4):31-6. [abstract]
    • Magdic, K. (1997). Integrating the acute care nurse practitioner into clinical practice: strategies for success. Dimensions of Critical Care Nursing 16(4): 208-1 [abstract]

APN Examinations

Pediatric Nurse Practitioner  Acute Care Certification Examination

The Pediatric National Certification Board (PNCB) is currently offering certification as a pediatric nurse practitioner in acute care. For more information please see the website: http://www.pncb.org/ptistore/control/product?prodId=EXAM-CPNP-2-AC&catalog=31&path=%7C


AACN

The American Nurses Credentialing Center offers certification for pediatric nurse practitioners. See website for more details.

CCNS - Certification for Adult, Neonatal and Pediatric Acute and Critical Care CNSs. See the Certcorp website for more details.

Pediatric Critical Care APNs & Professional Organization Activity

  • A committee of the Pediatric Section of SCCM meets annually during SCCM’s annual congress for APN’s in Pediatric Critical Care. Read more about this group and participate!
  • The Pediatric Section Advanced Practice Nurse Committee Meeting met February 3rd, 2008 in Hawaii at the 37th SCCM Critical Care Congress.
  • The next meeting will be held at the 38th SCCM Critical Care Congress in Nashville, TN, January 31-February 4, 2009.
  • Theresa Mikhailov MD (tmikhail@mcw.edu) and Mark Weber RN, PCCNP (mark.weber2@duke.edu) are the co-chairs of the committee.
  • The committee is in the final stages of developing a core curriculum for advanced practice nursing in pediatric critical care. This work group is being led by Lauren Sorce and Shari Simone. Updates to come soon.
  • How does one navigage SCCM?
    • There are two arms of interest to most pediatric APN's at SCCM - the Nursing Section and the Pediatrics Section. If you join SCCM you can chose up to 3 sections to join. Once you have joined the sections you will receive the blast emails that offer volunteer opportunities and dates/times of subcommmittee meetings. The committee meetings are open to all who would like to visit and participate. These meetings are a great way to meet other APN’s and get involved.
      • The Nursing Section meetings of interest are:
        • Advisory Council meeting
        • Business meeting
        • Membership subcommittee
        • Education subcommittee
        • Research subcommittee
        • Advanced Nursing Practice and Professional Development subcommittee
        • The Pediatrics Section meetings of interest are:
          • Advanced Practice Nursing committee
          • Business meeting

  • The National Association of Pediatric Nurse Practitioners (NAPNAP) http://www.napnap.org/index_home.cfm
    • The goals of the Acute Care SIG of NAPNAP include developing educational opportunities, providing a forum to discuss clinical practice, certification and legislative issues (via List-Serve and Newsletter) and designing multi-center research activities. Annual membership for this new SIG is $20. Nurse Practitioners must be a member of NAPNAP in order to join. For more information, or to join this new SIG, please contact-Kate Phillips (kphillips@napnap.org) at the NAPNAP national office (1-877-662-7627), or the co-chairs: Elizabeth Preze (epreze@childrensmemorial.org) or Lisa Milonovich (lmilono@aol.com)

Upcoming National Conferences for Pediatric Critical Care and Nursing

  • AACN National Teaching Institute – Chicago, Illinois, May 3-8, 2008
  • SCCM Critical Care Congress- Nashville, TN January 31-February 4, 2009
  • NAPNAP- Nashville Tennessee, April 14-17 2008
Last Updated: 2008-05-06 18:17:00
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