Pediatric Nursing: Scope and Standards of Practice
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About this ebook
Pediatric nursing focuses on the protection, promotion, and optimization of the health and abilities for children from newborn age through young adulthood. Utilizing a patient- and family-centered care approach, pediatric nurses strive for preventing illness and injury, restoring health, and maximizing comfort in health conditions and at the end of life, through diagnosis, treatment, and management of the child’s condition and advocacy in the care of children and families.
ANA and a workgroup of pediatric nurse experts, from across their specialty and representing seven professional organizations, convened to update and expand the 2008 edition to accommodate ongoing and anticipated changes in their specialty and health care. With input from numerous nurses, they developed Pediatric Nursing: Scope and Standards of Practice, 2nd Edition. It is a comprehensive delineation of the competent level of practice and professional performance common to and expected from pediatric registered nurses in all practice levels and settings.
The publication’s scope of practice addresses what is expected of all pediatric nurses, specifying the who, what, where, when, why, and how of their practice. That detailed discussion of the scope of practice gives the context—the underlying assumptions, characteristics, environments and settings, education and training requirements, key issues and trends, and ethical and conceptual bases of pediatric nursing—needed to understand and use the standards.
Those 16 standards, which offer a framework for evaluating practice outcomes and goals, are those by which all pediatric nurses are held accountable for their practice. The set of specific competencies accompanying each standard serves as evidence of minimal compliance with that standard.
A foundational volume that is primarily for those directly involved with pediatric nursing practice, education, and research, other nurses and allied healthcare providers, researchers, and scholars will find value in this content. It is also a resource for employers, insurers, lawyers, policy makers, regulators, and stakeholders involved in pediatric care.
About ANA’s Specialty Nursing Standards
Since the late 1990s, ANA has partnered with other nursing organizations to establish a formal process for recognition of specialty areas of nursing practice. This includes the criteria for approving the specialty itself and the scope statement, and an acknowledgment by ANA of the standards of practice for that specialty. Because of the significant changes in the evolving nursing and healthcare environments, ANA’s approval of specialty nursing scope statements and its acknowledgment of specialty standards of practice remain valid for five years, starting from the publication date of the documents.
The standards in this publication are based on language from ANA’s Nursing: Scope and Standards of Practice, Second Edition, a helpful supplement to this specialty text, which in turn is of optimal use with two complementary ANA texts: Nursing’s Social Policy Statement and Guide to the Code of Ethics for Nurses. Together, these three books help guide nursing practice, thinking, and decision-making. The set is proving useful as a professional reference, classroom textbook, in-service training guide, and credentialing exam resource.
American Nurses Association
The American Nurses Association (ANA) is the premier organization representing the interests of the nation's 4 million registered nurses. ANA is at the forefront of improving the quality of health care for all. Founded in 1896, and with members in all 50 states and U.S. territories, ANA is the strongest voice for the profession
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Pediatric Nursing - American Nurses Association
The American Nurses Association (ANA), National Association of Pediatric Nurse Practitioners (NAPNAP), and Society of Pediatric Nurses (SPN) are national professional associations. This ANA publication, Pediatric Nursing: Scope and Standards of Practice, Second Edition, reflects the thinking of the nursing profession on various issues and should be reviewed in conjunction with state board of nursing policies and practices. State law, rules, and regulations govern the practice of nursing, while Pediatric Nursing: Scope and Standards of Practice, Second Edition guides nurses in the application of their professional knowledge, skills, and responsibilities.
American Nurses Association
8515 Georgia Avenue, Suite 400
Silver Spring, MD 20910-3492
1-800-274-4ANA
http://www.Nursingworld.org
Copyright ©2015 American Nurses Association, National Association of Pediatric Nurse Practitioners, and Society of Pediatric Nurses. All rights reserved. Reproduction or transmission in any form is not permitted without written permission of the American Nurses Association (ANA). This publication may not be translated without written permission of ANA. For inquiries, or to report unauthorized use, email copyright@ana.org.
Library of Congress Cataloging-in-Publication is on file.
ISBN-13: 978-1-55810-637-6 SAN: 851-3481 11/2015
First published: November 2015
CO_image.psdContents
Contributors
Preface
Introduction
Function of the Scope of Practice Statement
Definition and Function of Standards
About This Book
Pediatric Nursing Standards
Summary
Scope of Pediatric Nursing Practice
Practice Context
Quality and Outcome Guidelines for Nursing of Children and Families
Healthcare Home
Patient- and Family-centered Care
Evidence-based Practice
Differentiated Areas of Pediatric Nursing Practice
Pediatric Registered Nurse
Pediatric Advanced Practice Registered Nurse
Regulatory Challenges for Advanced Practice Registered Nurses
Caring for a Diverse Population
Healthcare Transitions
Settings for Pediatric Nursing Practice: Pediatric Registered Nurse and Advanced Practice Registered Nurse
Inpatient and Acute Care Settings
Pediatric Home Healthcare Settings
Perioperative and Surgical Settings
Hospice and Palliative Care Settings
Ambulatory Care Settings
Community Health and School Settings
Camp Settings
Transport Settings
Specialty Settings for Pediatric Advanced Practice Registered Nurses
Trends and Issues in Pediatric Nursing
Global Perspectives of Pediatric Nursing
Complementary Therapies
Education
Certification
Regulation
Ethical Issues in Pediatric Care
Advocacy in Pediatric Care
Continued Commitment to the Profession
Standards of Pediatric Nursing Practice
Standards of Practice
Standard 1. Assessment
Standard 2. Diagnosis
Standard 3. Outcomes Identification
Standard 4. Planning
Standard 5. Implementation
Standard 5A. Coordination of Care
Standard 5B. Health Teaching and Health Promotion
Standard 5C. Consultation
Standard 5D. Prescriptive Authority and Treatment
Standard 6. Evaluation
Standards of Professional Performance
Standard 7. Ethics
Standard 8. Education
Standard 9. Evidence-based Practice and Research
Standard 10. Quality of Practice
Standard 11.Communication
Standard 12. Leadership
Standard 13. Collaboration
Standard 14. Professional Practice Evaluation
Standard 15. Resource Utilization
Standard 16. Environmental Health
Standard 17. Advocacy
References
Appendix A: Comprehensive List of Assessment Criteria for Pediatric Nursing
Appendix B: Pediatric Nursing: Scope and Standards of Practice (2008)
Index
CO_image.psdContributors
A work group cochaired by members from the National Association of Pediatric Nurse Practitioners (NAPNAP) and the Society of Pediatric Nurses (SPN), and composed of members of NAPNAP, SPN, the Pediatric Endocrinology Nursing Society (PENS), the Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN), the American Pediatric Surgical Nurses Association (APSNA), and the Society of Pediatric Cardiovascular Nurses (SPCN) developed Pediatric Nursing: Scope and Standards of Practice, Second Edition in collaboration with the American Nurses Association. It addresses pediatric nursing practice at all levels and in all settings to assist clinicians, educators, regulators, legislators, and the public.
Scope and Standards Writing Work Group Members
Patricia Clinton, PhD, RN, CPNP, FAANP, FAAN (Cochair, NAPNAP)
University of Iowa, College of Nursing, Iowa City, IA
Wayne Neal, MAT, BSN, RN-BC (Cochair, SPN)
Children’s National Medical Health Systems, Washington, DC
Isabel Couto, MSN, RN, CPN, NE-BC (PENS)
Novo Nordisk Inc., Plainsboro, NJ
Cathy Haut, DNP, CPNP-AC, CPNP-PC, CCRN (NAPNAP)
Beacon Pediatrics, Rehoboth Beach, DE; University of Maryland School of Nursing, Baltimore, MD
Jean B. Ivey, PhD, CRNP, PNP-PC, FAANP (NAPNAP and AFPNP)
University of Alabama at Birmingham, Birmingham, AL
Lynette A. Juluke, MSN, RN, CPN (SPN)
Everest College-Tyson’s Campus, McLean, VA
Diane Kocovsky, APRN (APGNN)
Boys Town National Research Hospital, Omaha, NE
Mary E. Lynch, RN, MS, MPH, PPCNP-BC, FAAN (SPN)
UCSF School of Nursing, San Francisco, CA
Carmel A. McComiskey, DNP, CRNP, FAANP (APSNA)
University of Maryland Medical Center; University of Maryland School of Nursing, Baltimore, MD
Mary Rummell, MN, RN, CNS, CPNP, FAHA (SPCN)
Oregon Health & Science University, Portland, OR
Scope and Standards Review Panel Work Group Members
Jan M. Foote, DNP, RN, ARNP, CPNP (PENS)
The University of Iowa College of Nursing, Iowa City, IA; Blank Children’s Hospital, Des Moines, IA
Lisa M. Kohr, RN, MSN, CPNP-AC/PCC, MPH, PhD(c), FCCM (SPCN)
Children’s Hospital of Philadelphia, Philadelphia, PA
Lynn Mohr, MS, APN, PCNS-BC, CPN (SPN)
Rush University College of Nursing, Chicago, IL
Lisa Philichi, MN, RN, CPNP (APGNN)
Mary Bridge Children’s Hospital and Health Center, Tacoma, WA
Pam Pieper, PhD, ARNP, PNP-BC (APSNA)
University of Florida College of Nursing; University of Florida College of Medicine, Division of Pediatric Surgery, Jacksonville, FL
Martha K. Swartz, PhD, RN, CPNP, FAAN (NAPNAP)
Yale University School of Nursing, New Haven, CT
ANA Committee on Nursing Practice Standards
Richard Henker, PhD, RN, CRNA, FAAN – Cochair (03/2014–12/2015)
Tresha (Terry) L. Lucas, MSN, RN – Cochair (07/2011–12/2014)
Danette Culver, MSN, APRN, ACNS-BC, CCRN
Deborah Finnell, DNS, PMHNP-BC, CARN-AP, FAAN
Renee Gecsedi, MS, RN
Deedra Harrington, DNP, MSN, APRN, ACNP-BC
Maria Jurlano, MS, BSN, RN, NEA-BC, CCRN
Carla A. B. Lee, PhD, APRN-BC, CNAA, FAAN, FIBA
Verna Sitzer, PhD, RN, CNS
American Nurses Association Staff
Carol J. Bickford, PhD, RN-BC, CPHIMS, FAAN – Content editor
Maureen Cones, JD – Legal counsel
Yvonne Humes, MSA – Project coordinator
Eric Wurzbacher – Project editor
NAPNAP Staff
Dolores C. Jones, EdD, RN, CPNP (Contributor) – Dean, Academic Affairs, Chamberlain College of Nursing
Eileen Arnold – NAPNAP Executive Assistant
About the National Association of Pediatric Nurse Practitioners
The National Association of Pediatric Nurse Practitioners (NAPNAP) is the professional association for pediatric nurse practitioners and other advanced practice registered nurses dedicated to improving the quality of health care for infants, children, adolescents, and young adults. NAPNAP has been advocating for children’s health since 1973 and was the first nurse practitioner professional society in the United States. Our mission is to empower nurse practitioners who work in pediatrics and their healthcare partners to enhance child and family health through practice, leadership, advocacy, education, and research. Along with superior clinical expertise and academic knowledge in primary, acute, and specialty health care, NAPNAP members include national child healthcare experts, respected authors, distinguished faculty, and practicing professionals in the delivery of pediatric health care (http://www.napnap.org/).
About the Society of Pediatric Nurses
The Society of Pediatric Nurses (SPN) is the premiere pediatric nursing association advancing the specialty of pediatric nursing through excellence in education, research, and practice. SPN is committed to promoting the care of children and their families through the development of evidence-based standards, visionary leadership, and life-long learning (https://www.pedsnurses.org/).
About the American Pediatric Surgical Nurses Association
The American Pediatric Surgical Nurses Association (APSNA) is the professional association for pediatric surgical nurses. APSNA’s mission is that all pediatric surgical patients will receive the highest quality nursing care that is patient and family centered, and its vision is to promote excellence in pediatric surgical nursing practice through educational offerings, nursing research, professional collaboration, and peer support. APSNA has been the leading association for pediatric surgical nursing issues since 1992, providing clinical expertise in this arena both in the outpatient and inpatient setting. Our members include national healthcare experts, authors, researchers, and distinguished faculty and leaders in pediatric surgical care (http://www.apsna.org/).
About the Association of Pediatric Gastroenterology and Nutrition Nurses
The Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN) is a North American organization of nurses and other medical professionals committed to the care of children, and their families, who have gastroenterology/nutrition illnesses. APGNN carries out its mission through the enhancement of professional development and education of patients and caregivers. Since inception in 1989, APGNN has promoted nursing research and education in pediatric gastroenterology and nutrition. APGNN has established standards of pediatric gastroenterology nursing practice while creating a nursing network to enhance professionalism in the discipline. That network continues to support the professional role development of pediatric gastroenterology and nutrition nurses (http://apgnn.org/).
About the Pediatric Endocrinology Nursing Society
The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement of nurses in the art and science of pediatric endocrinology nursing (http://www.pens.org/).
About the Society of Pediatric Cardiovascular Nurses
The Society of Pediatric Cardiovascular Nurses (SPCN) is the only international organization dedicated to expanding nursing knowledge and expertise in the care of children and young adults with heart disease. SPCN members are all involved in the care of children and young adults with congenital heart disease (CHD) and come from almost every state in the United States and eleven countries (http://spcnonline.com).
About the American Nurses Association
The American Nurses Association (ANA) is the only full-service professional organization representing the interests of the nation’s 3.4 million registered nurses through its constituent member nurses associations and its organizational affiliates. ANA advances the nursing profession by fostering high standards of nursing practice, promoting the rights of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the