The Acute Care PNP Faculty Series:
By us, for the kids
The Acute Care PNP Faculty Series arose from pervasive issues in nursing academia:
Faculty shortages, increasing workload, specialty practice, and the transition to competency-based education.
This series is a collaborative project between dozens of acute care pediatric nurse practitioner (PNP) faculty from across the United States who use The Peds NP to educate their students. The pediatric acute care role is vast and spreads from the intensive care unit, to inpatient hospitalist, emergency department, and subspecialty clinics, where each provider has honed unique and valuable skills to share with students. So we crowd-sourced our unique PNP expertise to bring our experience to episodes. The series used a novel approach to peer review and each episode achieved exceptional quality ratings based on academic podcast quality standards.
Background: Faculty Shortages
A national shortage of pediatric-focused clinicians threatens the health outcomes of millions of children across the country. A key component to bolstering the workforce and preparing future pediatric nurse practitioners is to support pediatric advanced practice faculty. The pediatric nursing faculty shortage is projected to continue to worsen in coming years as fewer faculty pursue academic nursing. That means that faculty must do more with fewer resources in an ever-advancing healthcare climate. The introduction of competency-based education in the American Academy of Colleges of Nursing’s latest Essentials introduces a new challenge for educators: Assessing student skills, rather than knowledge.
The Acute Care PNP Faculty
In May 2020, as the pandemic lockdown was threatening the progress of PNP students across the country, an acute care PNP faculty working group formed out of the National Association of Pediatric Nurse Practitioners (NAPNAP) Acute Care Special Interest Group. Once the pandemic subsided and working group dissolved, the collaborative group continued to work together on issues important to acute care PNP faculty and education. This series formed from these colleagues and the benevolent interest in sharing knowledge and expertise with one another’s students for the sake of creating skilled, competent future PNPs. Each episode author and reviewer volunteered their time to contribute to this meaningful educational product with the understanding that we create stronger students together.
Acute Care Topics Explained
The topics selected arose from a combination of factors. Each microlearning episode focuses on a single topic designed to convey key messages that faculty want to share with students, common issues experienced by students early in their programs, the practical application of skills-based competencies that students are likely to encounter in the clinical setting, or supporting the future workforce, both academically and personally.
Episodes
Your First Day of Acute Care Clinical (S11 Ep 68)
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(alphabetical)
Becky Carson, DNP, APRN, CPNP-PC/AC, Brittany Christiansen, PhD, DNP, APRN, CPNP-PC/AC, FNP-C, AE-C, CNE, Julie Kuzin, DNP, APRN, CPNP-PC/AC, Priscila Reid, DNP, FNP-C, CPNP-AC, Dani Sebbens, DNP, CPNP-AC/PC
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Welcome to The Peds NP Acute Care Faculty series! This collaborative series was created and peer-reviewed by national experts and leaders in acute care PNP education to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.
This episode welcomes the acute care PNP student to clinical, where you’ll learn important bedside lessons that apply your knowledge to practical situations. Our faculty offered advice on preparation, clinical rotation best practices, and how to finish the rotation successfully. There are key pearls and pitfalls to guide the student toward gaining competency in their newfound skills. We acknowledge those pesky doubts that cause imposter syndrome, and encourage the role of the learner. Through it all, your clinical is what you make of it, and you can be confident that you have the skills to competently enter a new role.
References:
Carley, A., & Garrett, L. (2022). Supporting Role Knowledge and Role Transition in Neonatal APRN Students. Neonatal network : NN, 41(3), 168–171. https://doi.org/10.1891/11-T-752
Clance, P. R., & Imes, S. A. (1978). The imposter phenomenon in high achieving women: Dynamics and therapeutic intervention. Psychotherapy: Theory, Research & Practice, 15(3), 241–247. https://doi.org/10.1037/h0086006
Edwards-Maddox S. Burnout and impostor phenomenon in nursing and newly licensed registered nurses: A scoping review. J Clin Nurs. 2023 Mar;32(5-6):653-665. doi: 10.1111/jocn.16475. Epub 2022 Aug 2. PMID: 35918887.
Lee, T., Lee, S. J., Yoon, Y. S., Ji, H., Yoon, S., Lee, S., & Ji, Y. (2023). Personal Factors and Clinical Learning Environment as Predictors of Nursing Students' Readiness for Practice: A Structural Equation Modeling Analysis. Asian nursing research, 17(1), 44–52. https://doi.org/10.1016/j.anr.2023.01.003
Scanlan JM, Laurencelle F, Plohman J. Understanding the impostor phenomenon in graduate nursing students. Int J Nurs Educ Scholarsh. 2023 Dec 7;20(1). doi: 10.1515/ijnes-2022-0058. PMID: 38053510.
White, A., & Rivera, L. (2023). Increasing Student Confidence Prior to an Obstetric Clinical Practicum. Nurse educator, 48(6), E195. https://doi.org/10.1097/NNE.0000000000001381
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6: Interprofessional partnerships
6.1 g, h
6.4 e
9: Professionalism
9.1 i
9.6 d, e
10: Personal, Professional, and Leadership Development
10.2 g
Developing the Acute Care Differential (S11 Ep 69)
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(alphabetical)
Aimee Bucci DNP, APRN, CPNP-AC, Becky Carson, DNP, APRN, CPNP-PC/AC, & Dani Sebbens, DNP, CPNP-PC/AC
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Welcome to The Peds NP Acute Care Faculty series! This series was created and peer-edited by national leaders in acute care PNP education collaborating with one another to meet the needs of our future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.
This episode will help guide the novice pediatric provider on how to create an acute care differential diagnosis. It starts with a throwback to a 1990’s classic song about adventures out on your own to frame some of the big concepts in differential diagnosis formulation. A brief case study on an adolescent with acidosis introduces the idea of broad differential formation and the importance of a complete evaluation before diagnoses are eliminated. Medical decision-making is difficult, and a systematic approach to differential diagnosis formation is essential. The episode uses simple examples to help listeners apply the concepts and form a differential in real time. The discussion covers the importance of careful accrual of information, initial differential creation, how to narrow your differential based on key findings of the assessment, and how to approach an open-ended differential honestly with families while avoiding cognitive bias. With the understanding that, “disease exists on a continuum that evolves and we see the patient at a snapshot in time,” the episode offers a step by step guide on how to build a differential. Classic mantras of The Peds NP are finally explained and tied to the development of your acute care differential. Every novice needs to listen to this episode before ever stepping foot in the clinical setting to be prepared for diagnostic reasoning and the process of narrowing your differential.
References:
Balogh, E. P., Miller, B. T., Ball, J. R., Committee on Diagnostic Error in Health Care, Board on Health Care Services, Institute of Medicine, & The National Academies of Sciences, Engineering, and Medicine (Eds.). (2015). Improving Diagnosis in Health Care. National Academies Press (US).
Brennan, M.M (2020). Teaching strategy 1: cultivating diagnostic decision-making with problem based learning: from most likely to least likely. Innovative Strategies in Teaching Nursing. doi: 10.1891/9780826161215
Carson, R. A., & Lyles, J. L. (2024). Cognitive Bias in an Infant with Constipation. The Journal of pediatrics, 113996. Advance online publication. https://doi.org/10.1016/j.jpeds.2024.113996
Hammond, M. E. H., Stehlik, J., Drakos, S. G., & Kfoury, A. G. (2021). Bias in Medicine: Lessons Learned and Mitigation Strategies. JACC. Basic to translational science, 6(1), 78–85. https://doi.org/10.1016/j.jacbts.2020.07.012Marshall, T. L., Rinke, M. L., Olson, A. P. J., & Brady, P. W. (2022). Diagnostic Error in Pediatrics: A Narrative Review. Pediatrics, 149(Suppl 3), e2020045948D.https://doi.org/10.1542/peds.2020-045948D
Marshall TL, Rinke ML, Olson APJ, Brady PW. Diagnostic Error in Pediatrics: A Narrative Review. Pediatrics. 2022;149(Suppl 3).
Smith, S.K., Benbenek, M.M., Bakker, C.J., & Bockwoldt, D. (2022). Scoping review: diagnostic reasoning as a component of clinical reasoning in the U.S. primary care nurse practitioner education. Journal of Advanced Nursing, 78:3869-3896. doi: 10.1111/jan.15414
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1: Knowledge for nursing
1.1 e, f
1.2 f, g
1.3 d, f
2: Person-centered care
2.3 h
2.4 f, g
How to Create Your First Abstract and Poster (S11 Ep 70)
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(alphabetical)
Becky Carson, DNP, APRN, CPNP-PC/AC and Mike Maymi, DNP, APRN, CPNP-AC, CCRN, CNE
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Welcome to The Peds NP Acute Care Faculty series! This series was created and peer-reviewed by national leaders in acute care PNP education collaborating with one another to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.
For many scholars, the poster and its prerequisite abstract are the first product of dissemination of their work. This episode guides the new scholar through the entire process from selecting a conference destination, writing the abstract in a succinct manner, creation of the poster, and the poster session at the conference. Key pearls and pitfalls of abstract submission, the use of artificial intelligence, and your final poster presentation complete the beginner’s guide to dissemination.
References:Barker, E., & Phillips, V.. (2021). Creating conference posters: Structure, form and content. Journal of Perioperative Practice, 31(7-8), 296–299. https://doi.org/10.1177/1750458921996254
Dave, T., Athaluri, S. A., & Singh, S. (2023). ChatGPT in medicine: an overview of its applications, advantages, limitations, future prospects, and ethical considerations. Frontiers in artificial intelligence, 6, 1169595. https://doi.org/10.3389/frai.2023.1169595
Drury, A., Pape, E., Dowling, M., Miguel, S., Fernández-Ortega, P., Papadopoulou, C., & Kotronoulas, G. (2023). How to Write a Comprehensive and Informative Research Abstract. Seminars in oncology nursing, 39(2), 151395. https://doi.org/10.1016/j.soncn.2023.151395
Freysteinson, W. M., & Stankus, J. A. (2019). The Language of Scholarship: How to Write an Abstract That Tells a Compelling Story. Journal of continuing education in nursing, 50(3), 107–108. https://doi.org/10.3928/00220124-20190218-04
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1: Knowledge for nursing
1.1 i
1.2 k
1.3 h
4: Scholarship for the nursing discipline
4.1 h, i, k, l
4.2 f
4.3 h, i
8: Informatics and healthcare technologies
8.2 f, g, h, i, j
9: Professionalism
9.3 i, j, k, n, o
9.5 f, g, h, i
10: Personal, professional, and leadership development
10.3 j, k, l, m, q
Delivering Bad News (S11 Ep 71)
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(alphabetical)
Jackie Calhoun, DNP, CRNP, CPNP-AC, CCRN, Becky Carson, DNP, APRN, CPNP-PC/AC, Lena Oliveros, MSN, CPNP-AC, Priscila Reid, DNP, APRN, FNP-C, CPNP-AC
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Welcome to The Peds NP Acute Care Faculty series! This series was created and peer-reviewed by national leaders in acute care PNP education collaborating with one another to meet the needs of our future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.
This episode reviews the features of a patient presentation in the pediatric intensive care unit (PICU) and goes in depth on how learners can incorporate trends, new findings, and summaries into a succinct discussion in family-centered rounds. After an introduction with some general best practices, the guide begins with effective pre-rounding and progresses to the step-by-step components of a PICU patient presentation. The template describes each component’s content in detail, followed immediately by an example to demonstrate the practical application of each concept. This episode is a valuable tool for any pediatric provider seeking to increase their skills in succinct synthesis and patient presentations, regardless of clinical setting.
References:
Bolick, B.N., Reuter-Rice, K., Madden, M.A., Severin, P.N. (2020). Pediatric Acute Care: A guide for Interprofessional Practice (2nd ed.). Jones & Barlett Learning. Burlington, MA.
Oubre, R. (2024). Systems versus problem-based notes. Dr. Oubre’s Digest. https://droubredigest.beehiiv.com/p/systems-versus-problems-based-notes
Stanford Medicine. (nd). Coaching best practices– Presenting a patient. https://med.stanford.edu/content/dam/sm/peds/documents/Program%20Information/coaching/Coaching%20Feedback%20Summary_Presenting%20a%20Patient.pdf
UC San Diego School of Medicine. (2018). Overview and general information about oral presentation. Practical Guide to Clinical Medicine. https://meded.ucsd.edu/clinicalmed/oral.html
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1: Knowledge for nursing
1.1 e, f
1.2 f, g, h
1.3 d, e
2: Person-centered care
2.2 g, i
2.3 h
2.4 f, g
2.5 h, i
2.6 e, f, g
4: Scholarship for the nursing discipline
4.2 f
6: Interprofessional partnerships
6.1 g, h, i, j, k
7: Systems-based practice
7.2 g, h
9: Professionalism
9.2 h, i, j, k, l
Case Study: Delivering Bad News (S11 Ep 72)
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(alphabetical): Becky Carson, DNP, APRN, CPNP-PC/AC, Ann Felauer, DNP, APRN, CPNP-PC/AC, Belinda Large, DNP, APRN, CPNP-PC/AC, and Robynn Stamm, DNP, APRN, CPNP-PC/AC
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This episode applies the concepts from the prior episode on “Delivering Bad News” (S11 Ep. 71) to a few examples where HIV status was disclosed to a pediatric patient. After reflection and discussion of a few ethical principles important to consent/assent, it’s time to practice delivering bad news in a case study. An unfolding case poses questions to get you thinking about what you might say. Make it interactive by pausing your podcast and answer the question yourself. The case walks you step-by-step through the process of delivering bad news to a child and their family using the SPIKES protocol. There's no perfect answer, but this example helps to prepare you for competency-based learning, so that you’re ready to deliver bad news in practice.
References
Brouwer, M. A., Maeckelberghe, E. L. M., van der Heide, A., Hein, I. M., & Verhagen, E. A. A. E. (2021). Breaking bad news: what parents would like you to know. Archives of disease in childhood, 106(3), 276–281. https://doi.org/10.1136/archdischild-2019-318398
Cassim, S., Kidd, J., Keenan, R., Middleton, K., Rolleston, A., Hokowhitu, B., Firth, M., Aitken, D., Wong, J., & Lawrenson, R. (2021). Indigenous perspectives on breaking bad news: ethical considerations for healthcare providers. Journal of medical ethics, medethics-2020-106916. Advance online publication. https://doi.org/10.1136/medethics-2020-106916
Field, M.J. & Behrman, R.E. (2003). When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Chapter 4 communication, goal setting, and care planning. Committee on Palliative and End-of-Life Care for Children and Their Families. Institute of Medicine (US)
Holmes, S. N., & Illing, J. (2021). Breaking bad news: tackling cultural dilemmas. BMJ supportive & palliative care, 11(2), 128–132. https://doi.org/10.1136/bmjspcare-2020-002700
Kaplan, M. (2010). SPIKES: A framework for breaking bad news to patients with cancer. Clinical Journal of Oncology Nursing, 14(4), 514-516. https://cjon.ons.org/cjon/14/4/spikes-framework-breaking-bad-news-patients-cancer
Kumar, V., & Sarkhel, S. (2023). Clinical Practice Guidelines on Breaking Bad News. Indian journal of psychiatry, 65(2), 238–244. https://doi.org/10.4103/indianjpsychiatry.indianjpsychiatry_498_22
Labaf, A., Jahanshir, A., Baradaran, H., & Shahvaraninasab, A. (2015). Is it appropriate to use Western guidelines for breaking bad news in non-Western emergency departments? A patients’ perspective. Clinical Ethics, 10(1–2), 13–21. https://doi.org/10.1177/1477750915581797
Monden, K. R., Gentry, L., & Cox, T. R. (2016). Delivering bad news to patients. Proceedings (Baylor University. Medical Center), 29(1), 101–102. https://doi.org/10.1080/08998280.2016.11929380
Mostafavian, Z., Shaye, Z. A., & Farajpour, A. (2018). Mothers' preferences toward breaking bad news about their children cancer. Journal of family medicine and primary care, 7(3), 596–600. https://doi.org/10.4103/jfmpc.jfmpc_342_17
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2: Person-centered care
2.1 d, e
2.2 g, h, i, j
6: Interprofessional Partnerships
6.1 g, i, k
6.2 g, i, j
9: Professionalism
9.1 i, k
9.2 i, j, k, l
9.3 l
9.6 g, h, i
Well-Being and Resilience (S11 Ep 73)
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(alphabetical): Becky Carson, DNP, APRN, CPNP-PC/AC, Ann Felauer, DNP, APRN, CPNP-PC/AC, Belinda Large, DNP, APRN, CPNP-PC/AC, and Robynn Stamm, DNP, APRN, CPNP-PC/AC
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This episode discusses a standardized approach to delivering bad news, founded in the literature. The SPIKES protocol is the most well recognized approach to create an environment, assess patient and family knowledge and preferences, deliver the news compassionately, and empathize prior to a summary. With examples of phrasing you can offer at each step, you’ll gain the skills necessary to deliver bad news.
References:
Brouwer, M. A., Maeckelberghe, E. L. M., van der Heide, A., Hein, I. M., & Verhagen, E. A. A. E. (2021). Breaking bad news: what parents would like you to know. Archives of disease in childhood, 106(3), 276–281. https://doi.org/10.1136/archdischild-2019-318398
Buckman R. (1984). Breaking bad news: why is it still so difficult?. British medical journal (Clinical research ed.), 288(6430), 1597–1599. https://doi.org/10.1136/bmj.288.6430.1597
Buckman R. (2001). Communication skills in palliative care: a practical guide. Neurologic clinics, 19(4), 989–1004. https://doi.org/10.1016/s0733-8619(05)70057-8
Institute of Medicine (US) Committee on Palliative and End-of-Life Care for Children and Their Families, Field, M. J., & Behrman, R. E. (Eds.). (2003). When Children Die: Improving Palliative and End-of-Life Care for Children and Their Families. Chapter 4 communication, goal setting, and care planning. National Academies Press (US).
Kaplan M. (2010). SPIKES: a framework for breaking bad news to patients with cancer. Clinical journal of oncology nursing, 14(4), 514–516. https://doi.org/10.1188/10.CJON.514-516
Ptacek, J. T., & Eberhardt, T. L. (1996). Breaking bad news. A review of the literature. JAMA, 276(6), 496–502.
Sisk, B., Frankel, R., Kodish, E., & Harry Isaacson, J. (2016). The Truth about Truth-Telling in American Medicine: A Brief History. The Permanente journal, 20(3), 15–219. https://doi.org/10.7812/TPP/15-219
Varkey B. (2021). Principles of Clinical Ethics and Their Application to Practice. Medical principles and practice : international journal of the Kuwait University, Health Science Centre, 30(1), 17–28. https://doi.org/10.1159/000509119
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2: Person-centered care
2.1 d, e
2.2 g, h, i, j
6: Interprofessional Partnerships
6.1 g, i, k
6.2 g, i, j
9: Professionalism
9.1 i, k
9.2 i, j, k, l
9.3 l
9.6 g, h, i
5-Minute Mindfulness for Pediatric Providers (S11 Ep 74)
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Becky Carson, DNP, APRN, CPNP-PC/AC
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Meditation begins at 2:00.
This 5-minute meditation for pediatric providers is designed to help you center your day before your work to boost your wellness, improve resilience, and connect better with yourself, your patients, and your colleagues.
First we’ll create a peaceful environment and establish the ground rules of meditation, then get your body into position. The guided meditation takes you through 5 minutes of breath to help you calm your mind and body while making room for empathy and patience. No judgment, but lots of kindness and compassion for your thoughts and feelings. The session ends by bringing body and mind back into your space and showing gratitude for the practice. Use this meditation every day before you go to work with infants, children, adolescents, and young adults to improve your wellness and their outcomes.
References:
The Meditation Initiative. (nd). 5 minute guided meditation script. https://meditationinitiative.org/5-minute-meditation-script
Mindful. (2024). How to start your day with meditation. https://www.mindful.org/how-to-start-your-day-with-meditation/
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10: Personal, Professional, and Leadership Development
10.1 c, d
Malnutrition and Feeding Tube Selection (S11 Ep 75)
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(alphabetical)
Becky Carson, DNP, APRN, CPNP-PC/AC, Bridget Sullivan Garmisa, MSN, MS, CRNP, RD
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This episode explores wellness for the pediatric nurse practitioner. We first discuss burnout in terms of its physical and mental impact on the provider as well as poorer patient outcomes and healthcare systems burdens. After we identify symptoms of burnout and compassion fatigue, we’ll discuss what wellness looks like in various systems at work from organizational culture of wellness to ease of daily work and finally personal resilience. We end with a discussion on self-compassion and introduce the evidence in support of meditation as a strategy to promote mind-body wellness. For some, this concept is new, so the technical aspects of meditation are unpacked to facilitate your own path to daily wellness. This episode pairs well with the 5-minute meditation for pediatric providers.
References:
Berwick, D. M., Nolan, T. W., & Whittington, J. (2008). The triple aim: care, health, and cost. Health affairs (Project Hope), 27(3), 759–769. https://doi.org/10.1377/hlthaff.27.3.759
Chan, G. K., Kuriakose, C., Blacker, A., Harshman, J., Kim, S., Jordan, L., & Shanafelt, T. D. (2021). An organizational initiative to assess and improve well-being in advanced practice providers. Journal of Interprofessional Education & Practice, 25, 100469-. https://doi.org/10.1016/j.xjep.2021.100469
Green, A. A., & Kinchen, E. V. (2021). The Effects of Mindfulness Meditation on Stress and Burnout in Nurses. Journal of holistic nursing : official journal of the American Holistic Nurses' Association, 39(4), 356–368. https://doi.org/10.1177/08980101211015818
Kabat-Zinn, J. (2005). Wherever You Go There You are (10th ed.). Hyperion
Kriakous, S. A., Elliott, K. A., Lamers, C., & Owen, R. (2021). The Effectiveness of Mindfulness-Based Stress Reduction on the Psychological Functioning of Healthcare Professionals: a Systematic Review. Mindfulness, 12(1), 1–28. https://doi.org/10.1007/s12671-020-01500-9
Leiter, M. P., & Maslach, C. (2004). Areas of worklife: A structured approach to organizational predictors of job burnout. In P. L. Perrewé & D. C. Ganster (Eds.), Emotional and physiological processes and positive intervention strategies (pp. 91–134). Elsevier Science/JAI Press.
Lennon, Y. (2023). The quintuple aim: What it is and why does it matter? Chess Health Solutions. https://www.chesshealthsolutions.com/2023/08/01/the-quintuple-aim-what-is-it-and-why-does-it-matter/#:~:text=The%20Quintuple%20Aim%20is%20an,system%20to%20establish%20health%20equity.
Makary, M. A., & Daniel, M. (2016). Medical error-the third leading cause of death in the US. BMJ (Clinical research ed.), 353, i2139. https://doi.org/10.1136/bmj.i2139
Maslach, C., Schaufeli, W. B., & Leiter, M. P. (2001). Job burnout. Annual review of psychology, 52, 397–422. https://doi.org/10.1146/annurev.psych.52.1.397
National Wellness Institute. (2024). NWI’s six dimensions of wellness. https://nationalwellness.org/resources/six-dimensions-of-wellness/#:~:text=Wellness%20is%20a%20conscious%2C%20self,a%20long%20and%20healthy%20life.
Neff, K. D. (2023). Self-Compassion: Theory, Method, Research, and Intervention. Annual Review of Psychology, 74(1), 193–218. https://doi.org/10.1146/annurev-psych-032420-031047
Panagioti, M., Khan, K., Keers, R. N., Abuzour, A., Phipps, D., Kontopantelis, E., Bower, P., Campbell, S., Haneef, R., Avery, A. J., & Ashcroft, D. M. (2019). Prevalence, severity, and nature of preventable patient harm across medical care settings: systematic review and meta-analysis. BMJ (Clinical research ed.), 366, l4185. https://doi.org/10.1136/bmj.l4185
Peters E. (2018). Compassion fatigue in nursing: A concept analysis. Nursing forum, 53(4), 466–480. https://doi.org/10.1111/nuf.12274
Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout. Mayo Clinic Proceedings, 92(1), 129–146. https://doi.org/10.1016/j.mayocp.2016.10.004
Shanafelt, T. D., Larson, D., Bohman, B., Roberts, R., Trockel, M., Weinlander, E., Springer, J., Wang, H., Stolz, S., & Murphy, D. (2023). Organization-Wide Approaches to Foster Effective Unit-Level Efforts to Improve Clinician Well-Being. Mayo Clinic Proceedings, 98(1), 163–180. https://doi.org/10.1016/j.mayocp.2022.10.031
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2: Person-centered care
2.1 d, e
2.8 f, g, h, i
3: Population Health
3.2 d, e, f, g
3.3 d, e, f
5: Quality and Safety
5.2 g, h
10: Personal, Professional, and Leadership Development
10.1 c, d
How to Select Enteral Formula and Start Feeds (S11 Ep 76)
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(alphabetical)
Becky Carson, DNP, APRN, CPNP-PC/AC, Marian Malone, DNP, APRN, CPNP-AC/PC, & Jessica D. Murphy, DNP, CPNP-AC, CPHON, CNE
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*This is the second episode in a 2 part series on enteral feeding. Listen to Episode 75: Malnutrition and Feeding Tube Selection first.
This episode walks through the decision-making for which enteral formula to select based on the patient's age, protein needs, and GI function. A list of commercially available examples is listed for each age group and protein type. Fluid and caloric goals are discussed to determine if concentrated formulas are appropriate. Lastly, the process of starting continuous feeds and advancing to bolus feeds while assessing for tolerance is reviewed. Build functional skills by following along with a case study that is continued from the prior episode. It's proof that there's more than just formula that goes into tube feedings.
References:
Bechtold, M. L., Brown, P. M., Escuro, A., Grenda, B., Johnston, T., Kozeniecki, M., Limketkai, B. N., Nelson, K. K., Powers, J., Ronan, A., Schober, N., Strang, B. J., Swartz, C., Turner, J., Tweel, L., Walker, R., Epp, L., & Malone, A. (2022). When is enteral nutrition indicated? Journal of Parenteral and Enteral Nutrition, 46(7), 1470–1496. https://doi.org/10.1002/jpen.2364
Becker, P., Carney, L. N., Corkins, M. R., Monczka, J., Smith, E., Smith, S. E., Spear, B. A., & White, J. V. (2014). Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition. Nutrition in Clinical Practice, 30(1), 147–161. https://doi.org/10.1177/0884533614557642
Green Corkins, K. (2015). Nutrition‐focused physical examination in pediatric patients. Nutrition in Clinical Practice, 30(2), 203–209. https://doi.org/10.1177/0884533615572654
Hess, L., & Crossen, J. (2008). Pediatric Nutrition Handbook (3rd ed.). Cincinnati Children’s.
Mehta, N. M., Skillman, H. E., Irving, S. Y., Coss-Bu, J. A., Vermilyea, S., Farrington, E. A., McKeever, L., Hall, A. M., Goday, P. S., & Braunschweig, C. (2017). Guidelines for the provision and assessment of Nutrition Support Therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Pediatric Critical Care Medicine, 18(7), 675–715. https://doi.org/10.1097/pcc.0000000000001134
Panchal, A. K., Manzi, J., Connolly, S., Christensen, M., Wakeham, M., Goday, P. S., & Mikhailov, T. A. (2014). Safety of enteral feedings in critically ill children receiving vasoactive agents. Journal of Parenteral and Enteral Nutrition, 40(2), 236–241. https://doi.org/10.1177/0148607114546533
Yi, Dae Young. (2018). Enteral nutrition in pediatric patients. Pediatric Gastroenterology, Hepatology & Nutrition, 21(1), 12-19. http://doi.org/10.5223/pghn.2018.21.1.12
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1: Knowledge for Nursing
1.2 l
2: Patient-Centered Care
2.3 k, m
2.5 n
How to Deliver a Patient Presentation in the PICU (S11 Ep 77)
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(alphabetical)
Becky Carson, DNP, APRN, CPNP-PC/AC, Marian Malone, DNP, APRN, CPNP-AC/PC, & Jessica D. Murphy, DNP, CPNP-AC, CPHON, CNE
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This episode begins with a brief review of malnutrition and pediatric nutritional assessment in acute care settings. Next we begin a choose-your-own-nutrition adventure by asking a series of questions that aid in medical decision-making for which nutrition route is appropriate, and, if enteral feeding is best, then determines the type of tube indicated. A case-based discussion with examples helps you to apply the concepts to a complex scenario. Our next episode will focus on formula selection, the initiation of feeds, and assessment of tolerance.
References:
Bechtold, M. L., Brown, P. M., Escuro, A., Grenda, B., Johnston, T., Kozeniecki, M., Limketkai, B. N., Nelson, K. K., Powers, J., Ronan, A., Schober, N., Strang, B. J., Swartz, C., Turner, J., Tweel, L., Walker, R., Epp, L., & Malone, A. (2022). When is enteral nutrition indicated? Journal of Parenteral and Enteral Nutrition, 46(7), 1470–1496. https://doi.org/10.1002/jpen.2364
Becker, P., Carney, L. N., Corkins, M. R., Monczka, J., Smith, E., Smith, S. E., Spear, B. A., & White, J. V. (2014). Consensus statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition. Nutrition in Clinical Practice, 30(1), 147–161. https://doi.org/10.1177/0884533614557642
Green Corkins, K. (2015). Nutrition‐focused physical examination in pediatric patients. Nutrition in Clinical Practice, 30(2), 203–209. https://doi.org/10.1177/0884533615572654
Hess, L., & Crossen, J. (2008). Pediatric Nutrition Handbook (3rd ed.). Cincinnati Children’s.
Mehta, N. M., Skillman, H. E., Irving, S. Y., Coss-Bu, J. A., Vermilyea, S., Farrington, E. A., McKeever, L., Hall, A. M., Goday, P. S., & Braunschweig, C. (2017). Guidelines for the provision and assessment of Nutrition Support Therapy in the pediatric critically ill patient: Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Pediatric Critical Care Medicine, 18(7), 675–715. https://doi.org/10.1097/pcc.0000000000001134
Panchal, A. K., Manzi, J., Connolly, S., Christensen, M., Wakeham, M., Goday, P. S., & Mikhailov, T. A. (2014). Safety of enteral feedings in critically ill children receiving vasoactive agents. Journal of Parenteral and Enteral Nutrition, 40(2), 236–241. https://doi.org/10.1177/0148607114546533
Yi, Dae Young. (2018). Enteral nutrition in pediatric patients. Pediatric Gastroenterology, Hepatology & Nutrition, 21(1), 12-19. http://doi.org/10.5223/pghn.2018.21.1.12
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1: Knowledge for Nursing
1.2 l
2: Patient-Centered Care
2.3 k, m
2.5 n
A Graduation Speech: Onward (S11 Ep 78)
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Becky Carson, DNP, APRN, CPNP-PC/AC
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This is the final episode of The Peds NP Acute Care PNP Faculty series. The series was created and peer-reviewed by national leaders in acute care PNP education in collaboration to meet the needs of our current and future colleagues. In the push for competency-based education where faculty verify the skills of what a student can do, rather than their knowledge, our series focuses on the application of didactic content with a practical approach so that you can learn nuances of clinical skills before you reach the bedside.
As I come to an end of my time as a faculty member at the Catholic University of America and our Acute Care PNP Faculty series, I remember my graduation from Johns Hopkins. These terminal moments are likened to a graduation, and serve as a wonderful time for reflection. The episode recollects the student speaker commencement address given at my graduation, filled with vehicular metaphors and acknowledgements of failure. A common theme of “Onward” is woven throughout to remind listeners that, at whatever graduation you find yourself celebrating right now, be hopeful and excited at the good that is left to do in the world.
The Peds NP will return in 2025 from Duke University…
References:
Carson, R.A. (2024). Student speaker commencement address [Speech transcript]. Johns Hopkins School of Nursing Commencement. https://alumni.jhu.edu/commencement-2016(Original work published 2016).
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10: Personal, Professional, and Leadership Development
10.1 c, d
10.2 g, i, j
10.3 j
Meet the AC PNP Faculty Contributors
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Becky Carson, DNP, APRN, CPNP-PC/AC
Duke University
HOST & PRODUCER, ACADEMIC TEAM LEAD
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Jenn Mauney, DNP, APRN, CPNP-AC
University of Florida
ACADEMIC TEAM
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Mike Maymi, DNP, APRN, CPNP-AC, CCRN, CNE
University of Florida
ACADEMIC TEAM, AUTHOR
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Ann-Marie Brown, PhD, APRN, CPNP-AC/PC, CCRN, CNE, FCCM, FAANP, FASPEN
Emory University
REVIEWER
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Aimee Bucci DNP, APRN, CPNP-AC
Arizona State University
AUTHOR
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Jackie Calhoun, DNP, CRNP, CPNP-AC, CCRN
University of Pittsburgh
AUTHOR
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Amy Carroll, MSN, APRN, CPNP-AC
University of Mississippi
REVIEWER
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Brittany Christiansen, PhD, DNP, APRN, CPNP-PC/AC, FNP-C, AE-C, CNE
University of California- San Francisco
AUTHOR
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Ann Marie Felauer, DNP, CPNP-AC/PC
University of Maryland
AUTHOR, REVIEWER
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Mary Flynn, DNP, APRN, CPNP
The Catholic University of America
REVIEWER
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Bridget Sullivan Garmisa, MSN, MS, CRNP, RD
Children’s Hospital of Philadelphia
AUTHOR & REVIEWER
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Remi Hueckel, DNP, APRN, CPNP-AC
Duke University
REVIEWER
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Jennifer Joyner, DNP, APRN, CPNP-AC
St. David’s North Austin Medical Center
REVIEWER
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Julie Kuzin, DNP, APRN, CPNP-PC/AC
Texas Tech University
AUTHOR
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Belinda Large, DNP, APRN, CPNP-PC/AC
Rush University
AUTHOR, REVIEWER
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Marian Malone, DNP, APRN, CPNP-AC/PC
University of Tennesee- Knoxville
AUTHOR & REVIEWER
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Emily McRae, DNP, APRN, CPNP-PC/AC
University of Louisville
REVIEWER
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JD Murphy, DNP, CPNP-AC, CPHON, CNE
Johns Hopkins University
AUTHOR & REVIEWER
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Tracy Ogdon, DNP, APRN, CPNP-AC
University of Illinois- Chicago
REVIEWER
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Lena Oliveros, MSN, APRN, CPNP-AC
University of Washington
AUTHOR
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Priscila Reid, DNP, APRN, FNP-C, CPNP-AC
Texas Tech University
AUTHOR
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Danielle Sebbens, DNP, APRN, CPNP-AC/PC
Arizona State University
AUTHOR & REVIEWER
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Robyn Stamm, DNP, APRN, CPNP-PC/AC
University of Cincinnati
AUTHOR
Peer Review Process
The Peds NP AC Faculty Series underwent an unprecedented and novel approach to peer editing. Focusing on quality standards set forth by healthcare podcast experts, our peer review process met scholarly podcast standards.
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Our faculty peer reviewed episodes prior to publication using a semi-blinded, standardized approach. Our tool was a modified version of the rMETRIQ score.
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The host assigns volunteer reviewers to a completed episode based on their academic interests and area of expertise. Reviewers are invited to share their credentials, clinical expertise relevant to the episode, and any disclose conflicts of interest.
Reviewers read the episode script and complete the multiple choice tool. Any episode with comments or imperfect scoring is edited and resubmitted to the reviewer to review again.