Regulation of pediatric intensive care unit nurse practitioner practice

Gigli, Kristin Hittle; Dietrich, Mary S.; Buerhaus, Peter I.; Minnick, Ann F.

doi:10.1097/jxx.0000000000000015

Cited by 14 publications

(11 citation statements)

References 32 publications

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“…Informed by the literature, streamlining and harmonising reporting structures helped in optimising NP resources (Gigli et al . 2018), minimising role confusion and improved NP retention and work efficiency.…”

Section: Discussionmentioning

confidence: 99%

Implementation of the Nurse Practitioner as Most Responsible Provider model of care in a Specialised Mental Health setting in Canada

Kipping

Riahi

Velji

et al. 2022

Int J Mental Health Nurs

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Globally, mental health systems have failed to adequately respond to the growing demands of mental health services resulting in a disparity between the need and provision of treatment. Paucity of mental health care providers contributes to the aforementioned disparity. This can be addressed by engaging Nurse Practitioners (NPs) in an integrated model within healthcare teams. This paper describes the implementation of NPs as Most Responsible Provider (MRP) care of model in a specialised mental health hospital in Ontario, Canada. Guided by the participatory, evidence‐based, patient‐focused process for advanced practise nursing (APN) role development, implementation, and evaluation (PEPPA) framework, authors developed a model of care and implemented the first seven steps of the PEPPA framework – (a) define the population and describe the current model of care, (b) identify stakeholders, (c) determine the need for a new model of care (d) identify priority areas and goals of improvement, (e) define the new model of care, and (f) plan and implement the NP as MRP model of care. Within these steps, different strategies were implemented: (a) revising policies and procedures (b) harmonising reporting structures, (c) developing and implementing a collaborative practise structure for NPs, (d) standardised and transparent compensation (e) performance standards and monitoring (f) Self‐Assessment Competency frameworks, education, and development opportunities. This paper contributes to the state of the knowledge by implementing NPs as MRP model of care in a specialised mental health care setting in Ontario, Canada; and advocates the need for incorporating mental health programmes within the Ontario nursing curriculum.

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Section: Discussionmentioning

confidence: 99%

Implementation of the Nurse Practitioner as Most Responsible Provider model of care in a Specialised Mental Health setting in Canada

Kipping

Riahi

Velji

et al. 2022

Int J Mental Health Nurs

View full text Add to dashboard Cite

show abstract

“…In addition, institutions that employ PICU NPs often place additional regulations on practice beyond those required by SSOP regulations through the process of credentialing and privileging (Gigli et al., 2018c). Some research suggests within-state variation in practice regulations may be more significant than interstate regulations for hospital-based NPs (Pittman et al., 2020).…”

Section: Discussionmentioning

confidence: 99%

“…While PICU’s increasingly incorporate NPs on provider teams, federal, state, and institutional policies may hamper NP role actualization and contributions to care delivery (Gigli et al., 2018c). Federal policy sets standards for NP reimbursement (MEDPAC, 2019).…”

Section: Discussionmentioning

confidence: 99%

Implications of State Scope-of-Practice Regulations for Pediatric Intensive Care Unit Nurse Practitioner Roles

Gigli

Martsolf

2021

Policy, Politics, & Nursing Practice

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Nurse practitioner (NP) advocacy efforts often focus on attaining full practice authority. While the effects of full practice authority in primary care are well described, implications for hospital-based NPs are less clear and may differ because of hospitals’ team-based care and administrative structure. This study examines associations between state scope-of-practice (SSOP) and clinical roles of hospital-based pediatric intensive care unit (PICU) NPs. We conducted a national survey to assess clinical roles of PICU NPs including daily patient care, procedural, and consultation responsibilities as well as hospital-level administrative oversight practices. We classified SSOP as full or limited (reduced or restricted SSOP) practice. We present descriptive statistics and evaluate differences in clinical roles and hospital-level administrative oversight based on SSOP. The final sample included 55 medical directors and 58 lead (senior or supervisory) NPs from 93 of the 140 (66.4%) PICUs with NPs. There were no significant differences in daily patient care, procedural, or consultation responsibilities based on SSOP ( p > .05). However, NPs in full practice authority states were more likely to bill for care than those in limited practice states (66.7% vs. 31.8%, p = .003), while those in limited practice states were more likely to report to advanced practice managers (36.7% vs. 13%, p = .03). For PICU NPs, SSOP was not associated with variation in clinical responsibilities; conversely, there were differences in billing and reporting practices. Future work is needed to understand implications of variation in hospital-level administrative oversight.

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“…Employment as a PNP often requires credentialing and the attainment of privileges to provide care that are unique and vary in different hospitals or health care systems (Gigli, Dietrich, Buerhaus, & Minnick, 2018b;The Joint Commission, n.d.). An orientation program associated with employee onboarding contributes to successful transitions into clinical practice and is encouraged as part of the professional development and mentorship of the PNP (Haut & Madden, 2015).…”

Section: Specialty Carementioning

confidence: 99%