Age Parameters for Pediatric Nurse Practitioner Practice

Age Parameters for Pediatric Nurse Practitioner Practice

Age Parameters for Pediatric Nurse Practitioner Practice

NAPNAP POSITION STATEMENT

NAPNAP Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice

The National Association of Pediatric Nurse Practitioners (NAPNAP) broadly defines the pediatric population cared for by pediatric nurse practitioners (PNPs) as all children from birth through 21 years of age and, in specific situations based on patient needs, individuals older than 21 years until care can be successfully transitioned to adult health care providers (American Academy of Pediatrics [AAP], American Academy of Family Physicians, and American College of Physicians, Transitions Clinical Report Authoring Group, 2011).

Age parameters for practice are only one criterion for population care and should not be the sole arbiter for optimal, safe, and quality care. ‘‘Circumstances exist in which a patient, by virtue of age, could fall outside the traditionally defined population focus of a PNP but, by virtue of special need, is best served by that PNP. Such patients may be identified as nontraditional patients for that PNP. In these circumstances, the PNP may man- age the patient or provide expert consultation to assure the provision of evidence-based care to those patients’’ (LACE APRN Network, 2012; AAP, 1988).

Age Parameters for Pediatric Nurse Practitioner Practice

Adopted by the National Association of Pediatric Nurse

Practitioners’ Executive Board on February 25, 2014. This

document replaces the 2008 NAPNAP Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice.

All regular position statements from the National Association of

Pediatric Nurse Practitioners automatically expire 5 years after

publication unless reaffirmed, revised, or retired at or before that time.

Correspondence: NAPNAP National Office, 5 Hanover Square,

Suite 1401, New York, NY 10004.

J Pediatr Health Care. (2014) 28, 15A-16A.

0891-5245/$36.00

Copyright Q 2014 by the National Association of Pediatric

Age Parameters for Pediatric Nurse Practitioner Practice

PNPs have the education, certification, and licensure to provide comprehensive care to pediatric patients. NAPNAP, partnered with the Association of Faculties of Pediatric Nurse Practitioners, recommend that PNPs be educated and prepared to provide quality health care to children and families. The National Organization of Nurse Practitioner Faculties (NONPF; 2012) established core competencies for all graduates of NP programs. In addition, there are established competencies for PNPs (primary care and acute care) that include essential knowledge and skills for providing health care to children from birth through young adulthood (National Organization of Nurse Practitioner Faculties, 2013).

All of the PNP national certification examinations include items related to the PNP’s role in caring for infants to young adults (American Nurses Credentialing Center, 2013; Pediatric Nursing Certification Board, 2010, 2012). Together, these organizations collaboratively use an evidence-based approach to create congruency among PNP educational programs, national certification standards, and PNP practice. As part of a health care team, PNPs can participate in

prenatal visits (Cohen, 2009). Their consultation with families of well children and those with prenatal diagnoses can foster strong patient-provider relationships. At the time of delivery, term and preterm infants present for care within multiple PNP practice environments. Preterm infants are recognized as a unique population with specialized health care needs (Agency for Healthcare Research and Quality, 2010). Research to improve care delivery for neonates has been a focus among PNP providers (Ahmed, 2010; Cockfield, Garner, Borders, 2012; Wells, Ahmed, & Musser, 2013).

The delivery of specialty care for this population should be enhanced through consultation as indicated. Many PNPswork in private practices or school health settings where some students, particularly children and youth with special health care needs, or college students, may be 21 years of age or older. The PNP is educated to meet the psychosocial and physical care needs of these students, participate in health promotion, deliver preventative care, and provide medical continuity (Keeton, Soleimanpour, & Brindis, 2012) to all children as they become young adults.

The importance of transition planning for adolescents to adult health care services has been widely acknowledged (McManus et al., 2013). Education, planning and support are needed for all adolescents pre- paring to transition to adult systems of health care. Adolescents with complex health care needs require additional coordination and guidance to ensure an optimal care transition (AAP, American Academy of Family Physicians, & American College of Physicians, Transitions Clinical Report Authoring Group, 2011; McManus, 2013). Pediatric health care providers, including PNPs, are qualified to assist patients from birth to age 21 years of age, adolescents and young adults older than 21 years of age with special health care needs, and young adult patients during the transition to adult health care services (NAPNAP & Society of Pediatric Nurses [SPN], in press).

Preparing adolescents with strategies to manage their health and negotiate the complexities of the adult health care system, adult health care home, and ancillary health systems empowers them and pro- motes success during the transition while establishing autonomy in an unfamiliar, challenging health care en- vironment (AAP, 2011). Age Parameters for Pediatric Nurse Practitioner Practice.

NAPNAP is an organization whose mission is to em- power PNPs and their health care partners to enhance child and family health through practice, leadership, advocacy, education, and research. NAPNAP firmly supports the scope of practice for PNPs to include prenatal consultations, newborns, infants, children, adolescents, and young adults. NAPNAP additionally supports the PNP’s role as a provider of health care for individuals older than 21 years with unique needs and for young adults during the transition to adult health care providers, especially among those living in communities with limited access to health care (AAP, American Academy of Family Physicians, & American College of Physicians, Transitions Clinical Report Authoring Group, 2011). To create exclusive age limits for pediatric patients may unnecessarily create barriers and limit access to health care for this population (LACE APRNNetwork, 2012; NAPNAP & SPN, in press).

The National Association of Pediatric Nurse Practitioners would like to acknowledge the contribution of the Professional Issues Committee and the following members for their contribution to this statement: Kristin Hittle, MSN, RN, CPNP-AC, CCRN, Chair, Professional Issues Committee; Beth Bolick, DNP, CPNP-AC, PPCNP-BC, CCRN; Andrea Kline-Tilford, MS, CPNP-

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AC/PC, FCCM; and Heather Keesing, MSN, RN, APRN (NAPNAP Staff).

REFERENCES Agency for Healthcare Research and Quality. (2010). Assessment

and care of the late preterm infant. Evidence-based clinical practice guideline. Retrieved from http://www.guideline.gov/ content.aspx?id=24066

Ahmed, A. H. (2010). Role of the pediatric nurse practitioner in pro- moting breastfeeding for late preterm infants in primary care settings. Journal of Pediatric Health Care, 24(2), 116-122.

American Academy of Pediatrics. (1988). Policy statement: Age limits of pediatrics (reaffirmed October 2011). Pediatrics, 81(5), 736, Retrieved from http://pediatrics.aappublications.org/content/ 129/2/e561.full

American Academy of Pediatrics, American Academy of Family Physicians, and American College of Physicians, Transitions Clinical Report Authoring Group. (2011). Supporting the health care transition from adolescence to adulthood in the medical home. Pediatrics, 128(1), 182-200.

American Nurses Credentialing Center. (2013). Test content outline: Pediatric primary care nurse practitioner board certification examination. Retrieved from http://www.nursecredentialing.org/ Documents/Certification/TestContentOutlines/PediatricNPTCO- Aug2013.pdf

Cockfield, C. M., Garner, G. D., & Borders, J. C. (2012). Follow-up after a failed newborn hearing screen: A quality improvement study. ORL Head and Neck Nursing, 30(3), 9-13.

Cohen, G. J. (2009). The prenatal visit. Pediatrics, 124(4), 1227-1232. Keeton, V., Soleimanpour, S., & Brindis, C. D. (2012). School based

health centers in an era of health care reform: Building on his- tory. Current Problems in Pediatric and Adolescent Health Care, 42(6), 132-156.

LACE APRNNetwork. (2012). Clarifying statement on age parameters for APRNs. Retrieved from http://login.icohere.com/connect/ d_connect_itemframer.cfm?vsDTTitle=Clarifying%20Statement %20on%20Age%20Parameters%20for%20APRNs&dseq= 11071&dtseq=63052&emdisc=2&mkey=public935&vbDTA= 0&viNA=0&vsDTA=&PAN=1&bDTC=0&blog=0&vsSH=A

McManus, M. A., Pollack, L. R., Cooley, W. C., McAllister, J. W., Lot- stein, D., Stickland, B., & Mann, M. Y. (2013). Current status of transition preparation among youth with special need in the United States. Pediatrics, 131(6), 1090-1097.

National Association of Pediatric Nurse Practitioners & Society of Pe- diatric Nurses. (in press). Pediatric nursing: Scope and standards of practice Silver Spring, MD: American Nurses Association.

National Organization of Nurse Practitioner Faculties. (2012). Nurse practitioner core competencies. Retrieved from http://c.ymcdn. com/sites/www.nonpf.org/resource/resmgr/competencies/ npcorecompetenciesfinal2012.pdf

National Organization of Nurse Practitioner Faculties. (2013). Population-focused nurse practitioner competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/ competencies/populationfocusnpcomps2013.pdf

Pediatric Nursing Certification Board. (2010). PNCB acute care PNP detailed content outline. Retrieved from http://www.pncb.org/ ptistore/resource/content/exams/ac/CPNP-AC_ExamContent Outline.pdf

Pediatric Nursing Certification Board. (2012). Primary care pediatric nurse practitioner certification exam. Retrieved from http:// www.pncb.org/ptistore/resource/content/exams/pnp/2012_ CPNP_Content_Outline.pdf

Wells, C., Ahmed, A., & Musser, A. (2013). Strategies for neonatal hyperbilirubinemia: A literature review. The American Journal of Maternal/Child Nursing, 38(6), 377-382.