Advanced neonatal nurse practitioner

INTRODUCTION: Intravenous therapy-related injury, its prevention, and treatment are ubiquitous topics of interest among neonatal clinicians and practitioners. This is due to the economic costs, reputational censure, and patents' wellbeing concerns coupled with the possibility of potentially avoidable serious and life-long harm occurring in this vulnerable patient population. CASE DESCRIPTION: A term infant receiving a hypertonic dextrose infusion for the management of hypoglycemia developed a fulminating extravasation shortly after commencement of the infusion...

BACKGROUND: Mentoring is a process in which a more skilled or experienced person builds a supportive relationship with a less experienced person to promote the latter's professional development. The National Association of Neonatal Nurse Practitioners (NANNP) supports the establishment of formalized mentoring programs for neonatal nurse practitioners (NNPs) and published a mentoring toolkit in 2017. Completing suggested activities outlined in the toolkit promotes the incorporation of evidence-based practice into the NNP professional role...

BACKGROUND: In 2017, the National Association of Neonatal Nurse Practitioners (NANNP) recommended that organizations implement formalized mentoring programs for neonatal nurse practitioners (NNPs). There is significant evidence to support that mentoring positively impacts nurse practitioners' job satisfaction and retention. However, there is a lack of evidence-based literature specific to NNP mentoring. PURPOSE: Determine the impact of participation in the NANNP formalized mentoring program on job satisfaction and retention for novice and experienced NNPs in an academic medical center in Tennessee...

BACKGROUND: In England, neonatal care is delivered in operational delivery networks, comprising a combination of the Neonatal Intensive Care (NICU), Local-Neonatal (LNU) or Special-Care Units (SCU), based on their ability to care for babies with different degrees of illness or prematurity. With the development of network care pathways, the most premature and sickest are mostly triaged for delivery in services linked to NICU. This has created anxiety for teams in LNU and SCU. Less exposure to sicker babies has resulted in limited opportunities to maintain expertise for when these babies unexpectedly deliver at their centre and thereafter require transfer for care, to NICU...

BACKGROUND: The COVID-19 pandemic necessitated sweeping changes in a neonatal nurse practitioner (NNP) program's approach to distance-accessible learning. Prioritizing student learning and safety, we developed a new alternative model for individualized simulation. METHOD: The scenario created for a student to deliver an unexpected diagnosis of trisomy 21, or Down syndrome, to a postpartum mother was redesigned to take place using web-conference technology. RESULTS: We successfully transitioned the planned in-person individualized simulation for NNP students delivering an unexpected diagnosis to a web-conference environment and added nurse-midwifery (NM) students...

Abdominal X-rays (AXRs) are one of the most common imaging modalities used to investigate suspected abdominal conditions in neonates. They are frequently requested for a variety of suspected conditions including necrotising enterocolitis, congenital diaphragmatic hernia, duodenal atresia and Hirschsprung's disease. Nurses play an important role in preparing and supporting neonates who are undergoing an AXR, and in some centres advanced neonatal nurse practitioners may be involved in requesting and interpreting AXRs as part of their enhanced role in patient management...

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...

BACKGROUND: The National Association of Neonatal Nurse Practitioners (NANNP) partnered with the National Certification Corporation (NCC) to invite all NCC-certified neonatal nurse practitioners (NNPs) to participate in a national survey on NNP compensation, workforce environment, and satisfaction measures. PURPOSE: To understand the current NNP compensation, benefits, and workforce environment. METHODS: An anonymous survey was sent to 6558 board-certified NNPs with 845 respondents...

BACKGROUND: Decisions about treatments for extremely preterm infants (EPIs) born in the 'grey zone' of viability can be ethically complex. This 2020 survey aimed to determine views of UK neonatal staff about thresholds for treatment of EPIs given a recently revised national Framework for Practice from the British Association of Perinatal Medicine. METHODS: The online survey requested participants indicate the lowest gestation at which they would be willing to offer active treatment and the highest gestation at which they would withhold active treatment of an EPI at parental request (their lower and upper thresholds)...

BACKGROUND: The need for neonatal advanced practice providers (APPs) has been described. Hospital training programs for neonatal physician assistants (PAs) have been developed by physicians. No publications exist about programs administered by neonatal APPs for both new graduate neonatal nurse practitioners (NNPs) and neonatal PAs. PURPOSE: The purpose of this work was to mentor, train, and hire neonatal APPs in a program administered by neonatal APPs. METHODS: We developed a 2-pronged approach to attract PAs and new graduate NNPs...

COVID-19 is a deadly global pandemic with scientific efforts improving our understanding of this novel coronavirus. No proven disease-specific therapies exist although various antiviral regimens offer some success. Many vaccines are in development and phase III clinical trial testing. COVID-19 thrives on medically fragile, elderly and socially disadvantaged, while children have been less affected. Children at risk are those with co-morbidities and neonates; the multisystem inflammatory syndrome is a severe version diagnosed in high-risk children...

BACKGROUND: There is increasing demand for neonatal advanced practice providers (APPs) and a shortage of neonatal nurse practitioners (NNPs). In many neonatal intensive care units, neonatal physician assistants are trained and hired, as well as new graduate NNPs. Neonatal APPs are utilized as mentors in a regional neonatology program in the Pacific Northwest. As part of a long-term goal to develop an educational program for neonatal APP mentors, an initial survey was administered. PURPOSE: The purpose of this survey was to raise personal insight and identify themes about 51 neonatal APP mentors' recollections of one's own worst and best mentorship experiences...

Housing insecurity has been shown to have an impact on the health care system due to negative maternal and neonatal outcomes. Housing insecurity is associated with the social determinants of health under the umbrella of economic stability and neighborhood/physical environments. Research shows that educational programs and support resources can help alleviate this strain for women who are pregnant. This article discusses the development and implementation of an advanced practice registered nurse (APRN)-led, prenatal education group for women facing housing insecurity who are pregnant and high risk...

OBJECTIVE:  Care offerings vary across medical settings and between families for babies with trisomy 13 or 18. The purpose of this qualitative descriptive study was to explore nurse, advanced practice practitioner, and neonatologist perspectives on care for babies with trisomy 13 or 18 in the intensive care unit. STUDY DESIGN:  Voice-recorded qualitative interviews occurred with 64 participants (41 bedside nurses, 14 advance practice practitioners, and 9 neonatologists) from two neonatal intensive care units (NICU) in the midwestern United States...

OBJECTIVE: To describe nurses' experience in the care of high-risk newborns. METHOD: This is a descriptive study with a qualitative approach, based on Merleau-Ponty's phenomenology and performed at the Fernando Magalhães Maternity Hospital in the state of Rio de Janeiro, through interviews with 30 nurses who work in neonatal care, according to the phenomenological thinking of Maurice Merleau- Ponty. RESULTS: Three categories emerged: "experienced body of the nurse practitioner on the high-risk newborn"; "experienced world of the nurse practitioner on the high-risk newborn"; and "time spent by the nurse practitioner with the high-risk newborn"...

There is a critical shortage of neonatal nurse practitioners (NNPs) in the United States. The NNP shortage increases workload and negatively affects job satisfaction, which ultimately impacts patient safety. Therefore, it is imperative to identify strategies to improve job satisfaction and retention. Authors of current evidence supported the connection between mentoring and role transition, job satisfaction, and intent to stay. Mentorship is key to the success of new graduate nurse practitioners as they develop confidence in the nurse practitioner (NP) role...

INTRODUCTION: The shortage of medical doctors in certain geographies and certain disciplines, resident work hour limitations and the demonstrated positive impact of advanced providers (nurse practitioners, physician assistants and clinical nurse specialists) on the quality and efficiency of care in numerous specialties have led to broader integration of advanced providers in healthcare organizations. With regard to pediatric surgery, some tertiary centers have successfully implemented 24/7 nurse practitioner coverage for their inpatient services...

BACKGROUND: A novel medical device has been developed to address an unmet need of standardizing and facilitating heart rate recording during neonatal resuscitation. In a time-critical emergency resuscitation, where failure can mean death of an infant, it is vital that clinicians are provided with information in a timely, precise, and clear manner to capacitate appropriate decision making. This new technology provides a hands-free, wireless heart rate monitoring solution that easily fits the clinical pathway and procedure for neonatal resuscitation...

STUDY OBJECTIVE: A gap analysis of emergency departments' (EDs') pediatric readiness across a health system was performed after the appointment of a service line health system pediatric emergency medicine (PEM) quality director. METHODS: A 55-question survey was completed by each eligible ED to generate a weighted pediatric readiness score (WPRS). The survey included questions regarding volume, ED configuration, presence of a pediatric emergency care coordinator (PECC), quality initiatives, policies and procedures, and equipment...

BACKGROUND: More than 90% of neonatal intensive care units (NICUs) in the United States are in urban areas, denying rural residents' easy NICU access. Telemedicine use for patient contact and management, although studied in adults and children, is understudied in neonates. A hybrid telemedicine system, with 24/7 neonatal nurse practitioner coverage and with a neonatologist physically present 3 days per week and telemedicine coverage the remaining days, was recently implemented at Comanche County Memorial Hospital's (CCMH) Level II NICU...