Health Care Quality and Outcome Guidelines for Nursing of Children and Families: Implications for Pediatric Nurse Practitioner Practice, Research, and Policy
Article Outline
Deborah Callender, MS, CPNP
Stafford Pediatrics
Stafford, Virginia
This brief article will present information of interest to pediatric nurse practitioners (PNPs) on the Health Care Quality and Outcome Guidelines for Nursing of Children and Families (hereafter referred to as Guidelines) developed by a coalition of pediatric and child and family nurses representing 12 professional organizations. A brief historical background of this major endeavor will be provided together with the follow-up activities that have occurred subsequently. Practice implications for PNPs will be discussed as well.
Beginning in 2001, the Expert Panel on Children and Families of the American Academy of Nursing embarked on an ambitious task of identifying the “gold standard” of child and family nursing care. This gold standard of nursing excellence was envisioned to provide the template for clinicians, educators, researchers, advocates, and policymakers to promote, improve, and enhance the level of health care provided to children and their families. This paradigm of excellence was conceived as a tool that clinicians could use to evaluate the quality of their care, educators could use as a framework for curriculum development in child and family nursing, researchers could use for testing, and child health proponents could use as an advocacy instrument (Feeg, 1999).
To accomplish this task, the Expert Panel invited representatives from 12 subspecialty nursing organizations, including the National Association of Pediatric Nurse Practitioners (NAPNAP) to participate in this effort. The process involved the collation of nursing care standards developed by this group of child and family nursing subspecialty organizations, as described in previous publications, that culminated in the development of Health Care Quality and Outcome Guidelines for Nursing of Children and Families (Box). A consumer guide was developed for families based on the Guidelines to assist them in evaluating the quality of care received by their children (Betz et al 2004, Craft-Rosenberg et al 2002).
Betz, Cowell, Lobo, & Craft-Rosenberg, 2004
Since the publication of the Guidelines, the primary effort of the Expert Panel has been directed to disseminating them to child and family nursing and interdisciplinary colleagues, families, health care policymakers, and the interested public. To this end, the Guidelines have been published in Nursing Outlook (2004), Pediatric Nursing (Feeg, 2005), Journal of Pediatric Nursing (Betz, 2005), and the Journal of Specialists in Pediatric Nursing (Foster, 2005) in an effort to distribute them broadly to child and family nursing professionals. The guidelines can also be accessed on the American Academy of Nursing Web site.
Additionally, Drs. Martha Craft-Rosenberg and Marilyn Krajicek (2006), one of the pairs of cochairs of the Child and Family Panel who oversaw this collaborative effort, served as coeditors for the contributed text, Nursing Excellence for Children and Families, written by members of the Expert Panel and based on the Guidelines. Each chapter of this text corresponds to one of the guidelines and contains a review and analysis of the evidence pertaining to the specific guideline, together with a discussion of the application to practice.
What are the practice implications of the Guidelines for PNPs who are either clinicians, educators, or researchers or involved in policymaking? PNPs in clinical practice can use these Guidelines to guide and direct their practice. These guidelines serve as the standard by which PNP clinical practice can be evaluated in terms of its quality. How these guidelines might be used in a clinical setting can be illustrated with this example. PNPs in the outpatient department of a major pediatric health care organization can assess the extent to which their nursing practice conforms to the listed Guidelines. Practice assessment of “Guideline 9—Children, youth, and families are directed to community services when needed” will provide the impetus to review practice guidelines currently used to determine the extent to which the population of children, youth, and families is referred to community services. Another strategy might include a continuous quality improvement audit to determine the level of practice. If an improvement in practice was identified, then measures such as staff development could be implemented.
Consumer guidelines based on the Guidelines can be distributed to families and youth to assist them in evaluating the quality of the care they receive. By using this tool, families and youth can be empowered not only to identify gaps or inadequacies in the level of health care their children or they receive but to know that they have the right to advocate for the high-quality care they deserve.
Faculty members in PNP graduate programs can use the Guidelines to ensure that the curriculum addresses these areas of practice that are considered to be the gold standard of nursing care for children and families. The text, Nursing Excellence for Children & Families (Craft-Rosenberg & Krajicek, 2006), is an excellent resource for nursing faculty to use in the curriculum development process.
Nurse researchers could use the Guidelines to serve as the framework for testing interventions to assess effectiveness. “Guideline 17—Children, youth, and families receive care that supports development” could be applied in testing a nursing intervention focused on supporting the child’s development that the PNP recommends, such as enrollment in a social skills group for a child with delayed development. PNPs interested in policymaking and children’s rights can use the Guidelines to advocate for changes in their health care organization, in their local community, or at the state and/or national level.
It is hoped that PNPs will join with their child and family nursing colleagues to use these Guidelines to guide their practice. No matter what our area of specialization or practice setting, we are all united in a collective effort to improve the quality of care provided to children, youth, and families.
References
- . Health care quality and outcome guidelines for nursing of children and families. Journal of Pediatric Nursing. 2005;20(3):149–152(May/June).
- . American Academy of Nursing Child and Family Expert Panel Health Care Quality and Outcomes Guidelines for Nursing of Children and Families: Phase II. Nursing Outlook. 2004;52:311–316
- . Nursing excellence for children & families. New York: Springer; 2006;
- . Report of the American Academy of Nursing Child and Family Expert Panel: Identification of quality and outcome indicators for maternal child health nursing. Nursing Outlook. 2002;50:57–60
- . Health care quality and outcome guidelines for nursing of children and families: From the AAN Expert Panel on Children and Families. Pediatric Nursing. 2005;31:19–150
- . Linking pediatric nursing standards across specialty organizational lines. Pediatric Nursing. 1999;25:582–583
- . The American Academy of Nursing’s guidelines for healthcare quality and outcomes: Implications for pediatric nursing practice. Journal of Specialists in Pediatric Nursing. 2005;10(3):99–102
Cecily L. Betz is Director, Nursing Training, University Center for Excellence in Developmental Disabilities, University of Southern California, Los Angeles, Calif.
Julia M. Cowell is Professor and Chair, Department of Community and Mental Health Nursing, Rush University, College of Nursing, Chicago, Ill.
Martha J. Craft-Rosenberg is Professor and Interim Dean, University of Iowa College of Nursing, Iowa City, Iowa.
Marilyn J. Krajicek is Professor, School of Nursing, University of Colorado Health Science Center, Denver, Colo.
Marie L. Lobo is Professor, College of Nursing, University of New Mexico, Albuquerque, N.M.
PII: S0891-5245(06)00548-7
doi:10.1016/j.pedhc.2006.08.008
© 2007 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
