Neonatal Provider Workforce

Abstract

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

Growing Neonatal Advanced Practice Providers via Mentorship Can Fill the Need

“…Other challenges included determination of the best content for both neonatal PA fellows and new graduate NNPs. Since the model of training NNPs has been suggested as appropriate for training neonatal PAs,1,2 and because the role responsibilities are similar, the content and competencies that are the basis of NNP education are used for the neonatal PAs. This is in contrast to the content provided when neonatal PA fellows attend neonatologist fellowship educational offerings, as in other neonatal PA fellowship programs 3,4.…”

Do We Nurture Our Young? Qualitative Conceptual Analysis of Worst and Best Mentorship Experiences Among Neonatal Advanced Practice Providers

“…Members of the American Academy of Pediatrics Committee on Fetus and Newborn have identified that neonatologists will increasingly need to collaborate with a variety of professionals, including APRNs and PAs, to meet the needs of the NICU population 7,28. Also, they recognized the training model for NNPs as well developed and how it may serve as a model for other NICU care providers 7,28.…”

“…Twenty-five percent of these respondents planned to increase the use of neonatal PAs in the future 6. The use of both NNPs and PAs as neonatal APPs has been supported by members of the American Academy of Pediatrics 7…”

The Pediatric Workforce: Recent Data Trends, Questions, and Challenges for the Future

“…[12][13][14] Many of the pediatric subspecialties have also raised concerns about workforce shortages. [15][16][17][18][19][20][21] With the recognition that pediatric physician-scientists have been the cornerstone for advances in genomics, precision medicine and biomedical research, the decline in the physician-scientist workforce adds further vulnerability. Physician scientists represent only 1.5% of the workforce and organizational strategies have been developed to improve the pipeline of adult and pediatric physician scientists.…”