The Future of Neonatal Advanced Practice Registered Nurse Practice

Staebler, Suzanne; Meier, Susan R.; Bagwell, Gail A.; Conway-Orgel, Margaret

doi:10.1097/anc.0000000000000243

Cited by 6 publications

(8 citation statements)

References 10 publications

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“…The nursing staff view the enhanced role and the increased responsibility of tasks such as taking WFDRI positively. This is supported by the literature around new pathways to advanced nursing practice 23 …”

Section: Discussionmentioning

confidence: 73%

Changed ophthalmic workload following introduction of digital retinal photography for retinopathy of prematurity screening

Tram

Golding

Lim

et al. 2021

Clinical Exper Ophthalmology

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Background ROP screening is vital in care of premature infants but is considered burdensome, difficult and time consuming for ophthalmologists. This study assessed the reduction in workload following the introduction of nurse‐led WFDRI to a large neonatal nursery. Methods We report a retrospective audit of 628 infants screened for ROP in the years 2010, 2013 and 2019 at the Royal Women's Hospital, Victoria. The last complete year of screening for ROP using binocular indirect ophthalmoscopy (BIO) alone (2010) was compared with two subsequent years after the introduction of nurse‐led WFDRI. The main outcome measures were the time taken to report and document WFDRI and the time taken to undertake BIO examination of a premature infant and document the results. Results The ophthalmologist's time taken to conduct BIO, review images and document the results per 100 patient examinations was reduced from 16.7 hours before introduction of WFDRI to 3.7 hours. Similarly, the weekly time spent on this component of ROP screening fell from 2.3 hours per week to 0.8 and 1.0 hours per week after introduction of WFDRI. Conclusions The introduction of nurse‐led WFDRI has resulted in a dramatic and sustained reduction in ophthalmologist workload involved in ROP screening in a large Australian neonatal nursery. This may result in improved retention of the ophthalmic workforce required to undertake ROP screening.

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Section: Discussionmentioning

confidence: 73%

Changed ophthalmic workload following introduction of digital retinal photography for retinopathy of prematurity screening

Tram

Golding

Lim

et al. 2021

Clinical Exper Ophthalmology

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“…85,86 Barriers to obtaining this education are lack of higher degree (ie, doctorate of nursing) programs, funding of faculty, access to preceptors, and federal and state regulations. 87 Regulations posed by the US Department of Education related to long-distance learning have had an effect on NNP education and have contributed to a drop in enrollment in states with significantly restrictive requirements. 87 Collaboration among educational institutions may be a strategy to overcome restrictive regulations and minimize costs and faculty needs.…”

Section: Initial and Ongoing Neonatal Competency Acquisition And Mainmentioning

confidence: 99%

“…87 Regulations posed by the US Department of Education related to long-distance learning have had an effect on NNP education and have contributed to a drop in enrollment in states with significantly restrictive requirements. 87 Collaboration among educational institutions may be a strategy to overcome restrictive regulations and minimize costs and faculty needs. 39 Locally, neonatal programs and hospitals can increase efforts to recruit more neonatal nurses within the workplace to pursue higher education as an NNP and offer tuition reimbursement or scholarships to assist with the financial burden.…”

Section: Initial and Ongoing Neonatal Competency Acquisition And Mainmentioning

confidence: 99%

Neonatal Provider Workforce

Keels

Goldsmith

Newborn³

2019

Pediatrics

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This technical report reviews education, training, competency requirements, and scopes of practice of the different neonatal care providers who work to meet the special needs of neonatal patients and their families in the NICU. Additionally, this report examines the current workforce issues of NICU providers, offers suggestions for establishing and monitoring quality and safety of care, and suggests potential solutions to the NICU provider workforce shortages now and in the future. To meet the critical and complex health needs of preterm neonates and neonates who are ill in the NICU, collaborative teams of health care providers work to render timely, safe, effective, efficient, and evidencebased care. 1 Many NICU provider teams include neonatologists, advanced practice registered nurses (APRNs), physician assistants (PAs), pediatric hospitalists, neonatal fellows, and pediatric residents. 1 In collaboration, these providers work together to consistently provide high-quality care throughout the neonatal hospitalization. Training and licensure are different for the various NICU provider groups. Most APRNs and PAs working in NICUs have completed master's or doctoral degree programs that require the acquisition of certain cognitive abilities and technical skills aimed at producing safe and effective patient care. 2,3 Neonatal nurse practitioners (NNPs) and pediatric nurse practitioners (PNPs) are registered nurses with advanced education and training to enable them to care for neonatal, infant, and pediatric patients, respectively, as APRNs. 4 PAs are educated as medical generalists in programs that include pediatric and adult medicine. 5 After graduating from a master's-or doctoral-level academic program and achieving national certification and state licensure, APRNs and PAs typically complete medical staff credentialing and a period of orientation to the provider role in the NICU on the basis of demonstrated skill sets and competencies. Pediatric hospitalists are physicians who have completed a graduate medical school program as well as a pediatric residency program that requires proficiency and skills in all areas of pediatrics, including neonatal medicine. 6 A minimum number of months in the newborn nursery and NICU settings are required as part of any

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“…The Advanced Practice Registered Nurse (APRN) Consensus Model outlines a pathway for licensed practice to the full extent of a nurse practitioner's (NP) certification and education (APRN Consensus Work Group & the National Council of State Boards of Nursing [NCSBN] APRN Advisory Committee Consensus model for APRN regulation, 2008). Each of the United States adopted components of this model to varying degrees, with 15 states fully implementing the model, thereby leading to improved patient outcomes and fewer hospital admissions (NCSBN, 2015; https://www.ncsbn.org/5397.htm; Staebler et al, 2016). States regulate APRN practice independently, leading to diversity in practice authority among states NCSBN, 2015; Reagan & Salsberry, 2013; Staebler et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

An exploration of perceived neonatal nurse practitioner authority in a restricted practice setting

Bailey

Staebler

Pont

et al. 2021

J Am Assoc Nurse Pract

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Background: Perceptions of autonomy in practice affect Neonatal Nurse Practitioner (NNP) job satisfaction, retention, and motivation to pursue NNP roles. However, Novice to Expert theory describes the processes for transitioning to nurse practitioner roles are not in relationship with NNP practice autonomy. Purpose: Relationships between Advanced Practice Registered Nurse (APRN) practice authority, state restrictions, APRN volume, and health care access exist. However, do APRN perceptions of autonomy relate to motivation to pursue practice authority? This study provides an exploration of perceptions of NNP practice autonomy in this context. Methodology: Semistructured interviews conducted with NNPs and neonatologists practicing in a restricted setting explored perceptions of practice expertise and autonomy, based on Patricia Benner's Novice to Expert theoretical framework. Laddered methodology organized survey questions, and the Framework Method was used for analysis of results. Results: The majority of eligible NNPs (n = 12, 67%) and neonatologists (n = 8, 67%) agreed to study participation. Identified themes were grouped into larger concepts, including “NNP practice authority,” “NNP expertise,” and “NNP autonomy.” For example, “NNP expertise” included the theme “determining NNP expertise” and associated factors included “procedural skills,” “years and acuity of practice level,” and “confidence in management plan and emergent situations.” Conclusions: Both neonatologists and NNPs perceived neonatologists as a practice authority with support for NNP autonomy. Factors indicating NNP expertise correlated with domains in Benner Novice to Expert theory. Implications: These findings support previous work concerning the evolution of expertise and transition to practice. More inquiry to understand perspectives of APRNs in restricted practice settings is indicated.

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The Future of Neonatal Advanced Practice Registered Nurse Practice

Cited by 6 publications

References 10 publications

Changed ophthalmic workload following introduction of digital retinal photography for retinopathy of prematurity screening

Changed ophthalmic workload following introduction of digital retinal photography for retinopathy of prematurity screening

Neonatal Provider Workforce

An exploration of perceived neonatal nurse practitioner authority in a restricted practice setting

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