1. Pediatric Nurses: Who are they and What do they do ? A Profile of School Nurses and Certified Pediatric Nurses (CPNs ® ) Janet S. Wyatt, PhD, RN, FAANP Executive Director – IPN Sandi Delack, MEd, RN, NCSN NASN Past President & IPN Board Member

2. Certified Pediatric Nurse (CPN ® ) Exam Launched 1989 Founding Leadership – Donna Wong, PhD, RN, CPN Total Certified Oct 2011 = 15,220

3. Definition of Pediatric Nursing Includes health promotion, acute & chronic illness management and health restoration of infants, children, adolescents & their families. Pediatric nurses practice in a variety of settings & roles such as direct caregiver, educator, consultant, advocate, or care coordinator. Pediatric nurses assess, analyze, plan & implement nursing interventions & evaluate outcomes.

4. PNCB’s 2008 Practice Analysis Study Practice Analysis - Largest research survey ever completed of practicing pediatric nurses – over 2800 respondents Respondents identified a total of 72 pediatric nursing knowledge competencies and tasks critical to pediatric nursing practice These competencies and tasks are reflected in the exam Knowledge & Skills linked to pediatric nursing practice??

5. Total CPNs = 15,220 89%

6. CPNs by Highest Degree (n= 15,220) 66% 25% 9%

7. Dedicated, Experienced - CPN ® s  Certified an average of 6 yrs (range 0-30 yrs)  With current employer = 13 yrs (range 0-49 yrs)  93% Plan to remain with current employer for next six months

8. Examples of Competencies/Tasks on the CPN Exam Assessment Assess physical status, growth and development Assess nutritional status of child Assess barriers to care Assess & report signs of abuse and neglect Health Promotion Teach health promotion strategies to child/family e.g. safety, infection control Discuss environmental factors that influence health

9. Examples (cont.) Management Monitor for patient responses and adverse reaction to medication Manage pain Identify and intervene when patient needs immediate care Nursing procedures (e.g. physiological monitoring, F&E admin., med. admin.)

10. Top Five Illness Conditions Respiratory Gastrointestinal Infectious Disease Neurology Emergency Trauma

11. CPN Exam Content Outline (cont.) Professional Role Incorporate evidence-based findings into practice Participate in disaster preparedness Recognize legal applications in clinical situations (e.g. assent)

12. 2008 CPN ® Content Outline (150 questions) Assessment (30% ) Physical – Growth and development Psychosocial/Family Health Promotion (10%) Management (50%) Illness Psychosocial/Behavioral Chronic Care/End of Life Professional Role (10%)

13. Pediatric Nursing Scope and Standards of Practice. A collaborative document combining pediatric nursing Scope & Practice documents from the ANA, SPN and NAPNAP Six Standards of Pediatric Nursing Practice ◊ Assessment ◊ Planning ◊ Diagnosis◊ Implementation ◊ Outcomes Identification ◊ Evaluation 2008 Pediatric Nursing Scope and Standards

14. 11 Standards of Professional Performance 2008 Pediatric Nursing Scope and Standards ◊ quality of practice ◊ education ◊ collegiality ◊ collaboration ◊ professional accountability ◊ ethics ◊ resource utilization ◊ leadership ◊ research ◊ advocacy ◊ professional practice evaluation 2008 – Published by ANA, NAPNAP and SPN

15. “School nursing is a specialized practice of professional nursing that advances the well being, academic success, and life-long achievement of students. To that end, school nurses facilitate positive student responses to normal development; promote health and safety; intervene with actual and potential health problems; provide case management services; and actively collaborate with others to build student and family capacity for adaptation, self management, self advocacy, and learning.”

16. NASN Membership Survey Results (~15,000) 92% Caucasian 29% Nationally Certified (NCSN) 14% > 36 years experience 86% public schools

17. Education 50% Bachelors 28% Masters 10% Associate *3% are NPs

18. Most work directly for public schools All work within public health. NASN 2007 Membership Survey

20. National ratio of RN to students = 1:1151

21. 27% HEALTH APPRAISAL 28% HEALTH PROBLEMS AND NURSING MANAGEMENT 20% HEALTH PROMOTION/DISEASE PREVENTION 10% SPECIAL HEALTH ISSUES 15% PROFESSIONAL ISSUES National Board for Certification of School Nurses 250 test questions

22. Does your district/school use electronic student health records? 56% use electronic health records (2009 NASN Survey) Potential New Knowledge/ Practice Competency

23. Emerging Issues Affecting School Nursing Practice More school children are uninsured, underinsured and undocumented – public health departments depend on school health services for these children Increasingly complex care is provided in schools to medically fragile children and children with chronic health issues - schools hiring RNs to serve specific (special needs) students due to regulatory requirements Physical and psycho-social health status of children is confounded by new social and environmental threats Fragmented & underfunded school health resources

24. CPN Assessment (30% ) Physical Assessment Psychosocial and G & D Health Promotion (10%) Management (50%) Illness Psychosocial/Behavioral Chronic Care/End of Life Professional Role (10%) NCSN 27% HEALTH APPRAISAL 28% HEALTH PROBLEMS AND NURSING MANAGEMENT 20% HEALTH PROMOTION/DISEASE PREVENTION 10% SPECIAL HEALTH ISSUES 15% PROFESSIONAL ISSUES Is this content in Undergrad BSN/RN Education ? Knowledge Expectations in Pediatric Nursing Practice

25. Are We Preparing Nurses For These Important Roles?

26. Thank You! QUESTIONS?