Journal of Pediatric Health Care

Posttraumatic Stress Disorder

Gail Hornor — 2012-10-01

Abstract: Children are exposed to a variety of traumatic experiences, and each child is unique in his or her response to that trauma. The most common psychiatric disorder that develops after exposure to trauma is posttraumatic stress disorder (PTSD). This article will help pediatric nurse practitioners understand PTSD in terms of diagnosis, epidemiology, risk factors, comorbidity, and treatment. DSM-IV diagnostic criteria will be discussed, along with modifications to consider when evaluating very young children for PTSD. Implications for practice will be discussed along with suggested questions to ask parents and children to assess for exposure to trauma.

Protecting the Privacy Rights of Adolescents

Martha Kirk Swartz — 2013-05-01

Privacy and security of health information are now considered to be basic rights of patients. Unfortunately, the Health Insurance Portability and Accountability Act of 1996, and Health Information Technology for Economic and Clinical Health Act of 2009 appear to offer little to address the unique privacy needs of minors and young adults, who may routinely seek health care under their parents' supervision and as part of their parents' insurance coverage.

The Role of Nurse Practitioners in Pediatric Mental Health

Susan N. Van Cleve — 2013-05-01

Many of you will agree that expecting the unexpected is one of the best aspects of our role as nurse practitioners (NPs). For me, this has come in the form of a practice in developmental behavioral pediatrics and mental health that has brought me the opportunity to support families in need while gaining immeasurable professional satisfaction.

Anticipatory Guidance Preferences of Latina Migrant Farmworker Mothers

Jill F. Kilanowski — 2011-09-29

Abstract: Introduction: The purpose of the study was to learn preferences of Latina migrant farmworker mothers regarding the presentation of health education materials by discussing the strengths and weaknesses of numerous mixed-media samples.Method: This community-based participatory study was qualitative and descriptive in design. Focus groups were conducted in Spanish in four Midwest migrant camps with a convenience sample of mothers (N = 31). Adult learning and cultural care theories guided the study. Various modes of educational materials on various topics were presented.Results: Mothers preferred comic book-style handouts, games, food replicas, text in English/Spanish, and digital video discs or digital versatile discs, but almost none of them had media-playing equipment. They did not like black-and-white photos or cartoon-like illustrations. Identified themes of importance were colored illustrations, sizes mothers could easily carry in purses, and limited verbiage on a page.Discussion: The knowledge gained in this study will be used to customize health promotion interventions that are sensitive to migrant farmworker-preferred learning styles. The findings from this study can inform other interventions with Latino populations and serve as a prototype for other populations of immigrant non–English-speaking mothers.

Provider Use of Corrected Age During Health Supervision Visits for Premature Infants

2011-10-28

Abstract: Introduction: Correcting age for prematurity is recommended by the American Academy of Pediatrics and the Centers for Disease Control and Prevention. The use of chronological age instead of corrected age for infants born prematurely may result in incorrect interpretations regarding the adequacy of a child’s growth or developmental progress and has the potential to negatively affect care. This study examined the frequency and impact of the use of corrected age by primary care providers.Method: A retrospective cross-sectional electronic health record review was performed for all infants < 32 weeks’ gestation who were seen for a health supervision visit in a 31-site pediatric network during a 1-year period. Primary care providers used an electronic health record that defaulted to chronological age information.Results: Primary care providers used corrected age for developmental surveillance for 24% of visits, they used chronological age for 71% of visits, and the age used was unclear in 5% of visits. The lower a child’s gestational age and the more that chronological age was used, the more concerns were identified by primary care providers. Dietary changes that included the introduction of solid foods, the start of fluoride, and the introduction of milk typically were recommended on the basis of chronological age.Discussion: Primary care providers used chronological age more than corrected age, which influenced assessment and recommendations for care. This study illustrates the impact of not using corrected age, the importance of ensuring that care aligns with guidelines, and the possible influence of the design of the electronic health record on patient care. Because families of premature infants rely on primary care providers to accurately identify sequelae associated with prematurity, and to provide reassurance when it is warranted, these findings have implications for all health care providers who treat premature infants.

The Asian American Family and Mental Health: Implications for Child Health Professionals

Jeena Jacob, Barbara Gray, Ann Johnson — 2011-11-18

Abstract: The Asian American community has grown significantly in the United States during recent decades. The culture of their countries of origin as well as the society in which they currently live plays a pivotal role in their reaction to mental health and illness. Mental health issues are increasingly evident in Asian American communities. The need for the delivery of culturally competent health care and mental health services is paramount. A culturally competent framework that includes the use of a cultural competence model for practice can guide the health care provider in the recognition of problems, particularly in the children of Asian American families.

The Routine Use of Chest Radiographs After Chest Tube Removal in Children Who Have Had Cardiac Surgery

Cathy S. Woodward, Donna Dowling, Richard P. Taylor, Carol Savin — 2011-12-19

Abstract: Background: It is routine to obtain a chest radiograph (CXR) after removal of a chest tube (CT) to assess for pneumothorax. Retrospective studies have shown that clinical signs were present in most children with pneumothorax and were an indication for a CXR.Objective: Our objective was to determine if clinical indicators of pneumothorax are sufficient predictors of the need for CT reinsertion in children who have had a CT removed after cardiac surgery.Methods: The prospective study included a physical assessment before CT removal, using a two-person technique, which was repeated 2 hours after CT removal. Based on assessment findings, a decision was made regarding whether a CXR was indicated. The routine CXR was then obtained and read by a pediatric intensivist who was blinded to the decision of the investigator.Results: Sixty CTs were removed in 53 children. No false-positive predictions were made, because none of the children was predicted to have a pneumothorax requiring chest tube reinsertion, and none developed a significant pneumothorax (95% confidence interval: 0, 5%).Conclusions: The low rate of pneumothoraces in this study may be been related to how the CT was placed in surgery, the type of CT used, or the method of removal. In this study the risk of developing a pneumothorax requiring CT reinsertion after CT removal was at most 5% and therefore low enough to consider obtaining a CXR for symptomatic children only.

Novice to Expert: The Evolution of an Advanced Practice Evaluation Tool

2012-01-09

Abstract: Professional performance evaluation provides an opportunity to measure the practice of health providers within healthcare settings. Standardized evaluation can be challenging as a result of diverse practice arenas, multiple evaluators and standards of care. Using Benner’s novice to expert model, a Performance Excellence and Accountability tool (PEAC Tool©) has been designed to measure advanced practice providers performance based upon facets of professional practice. This article discusses development, practical implementation and evaluation of a PEAC Tool©.

Medical Home and Pediatric Primary Care Utilization Among Children With Special Health Care Needs

2012-01-16

Abstract: Introduction: The medical home model seeks to improve health care delivery by enhancing primary care. This study examined the relationship between the presence of a medical home and pediatric primary care office visits by children with special health care needs (CSHCN) using the data from 2005-2006 National Survey of Children with Special Healthcare Needs.Method: Survey logistic regression was used to analyze the relationship.Results: When CSHCN age, gender, ethnicity/race, functional status, insurance status, household education, residence, and income were included in the model, CSHCN with a medical home were 1.6 times more likely to have six or more annual pediatric primary care office visits than were children without a medical home [odds ratio = 1.60, 95% confidence interval = (1.47, 1.75)]. Female CSHCN, younger CSHCN, children with public health insurance, children with severe functional limitations, and CSHCN living in rural areas also were more likely to have a larger number of visits.Discussion: By controlling for child sociodemographic characteristics, this study provides empirical evidence about how medical home availability affects primary care utilization by CSHCN.

Menorrhagia and Rash in a Female Adolescent

Rachel Berquist — 2012-05-21

Jo Ann Serota, DNP, RN, CPNP

Vitamin K Deficiency Bleeding: Overview and Considerations

Caroline W. Burke — 2012-11-12

Karin Reuter-Rice, PhD, CPNP-AC, FCCM

Changing the Outcomes of Pediatric Drug Trials: APNs Making a Difference

Michelle Dickey, Peggy Clark — 2013-02-25

Rita H. Pickler, PhD, RN, PNP-BC, FAAN

Evaluation of a Newborn With a Murmur

Yuliya Turiy — 2012-06-04

The incidence of murmurs in children has been reported to be as high as 90% (). However, the prevalence of structural heart disease is only 8 to 10 per 1000 live births, with approximately one quarter of these children having critical congenital heart disease (CHD), defined as requiring surgical or catheter intervention in the first year of life (). Therefore it is the job of the primary care provider to identify the newborns who require investigation of their murmur. This article will focus on the assessment of an otherwise well newborn infant presenting with a murmur.

Nurse and Physician Attitudes Toward the Development of a Critical Care Pediatric Nurse Practitioner Role

Robyn E. Huey — 2013-05-01

Andrea Kline Tilford, MS, RN, CPNP-PC/AC, CCRN, FCCM

2013-05-01

Editorial Board Page

2013-05-01

Society

2013-05-01

Information for Readers

2013-05-01

NAPNAP Position Statement on School-Based Health Care

2013-05-01

School-based health centers (SBHCs), which are located on or near school campuses, provide comprehensive primary care to infants, children, and adolescents living or attending school in the local area. SBHCs are a safe and convenient source of health care for children who may not otherwise have access to care. The National Association of Pediatric Nurse Practitioners (NAPNAP) supports the use of primary care pediatric nurse practitioners in SBHCs to maximize access to health care for children by providing comprehensive primary care, managing acute and chronic illnesses, and linking these services with other community resources.

NAPNAP Update

2013-05-01

Tresa Zielinski, DNP, RN, CPNP-PC

Journal of Pediatric Health Care

Posttraumatic Stress Disorder

Protecting the Privacy Rights of Adolescents

The Role of Nurse Practitioners in Pediatric Mental Health

Anticipatory Guidance Preferences of Latina Migrant Farmworker Mothers

Provider Use of Corrected Age During Health Supervision Visits for Premature Infants

The Asian American Family and Mental Health: Implications for Child Health Professionals

The Routine Use of Chest Radiographs After Chest Tube Removal in Children Who Have Had Cardiac Surgery

Novice to Expert: The Evolution of an Advanced Practice Evaluation Tool

Medical Home and Pediatric Primary Care Utilization Among Children With Special Health Care Needs

Menorrhagia and Rash in a Female Adolescent

Vitamin K Deficiency Bleeding: Overview and Considerations

Changing the Outcomes of Pediatric Drug Trials: APNs Making a Difference

Evaluation of a Newborn With a Murmur

Nurse and Physician Attitudes Toward the Development of a Critical Care Pediatric Nurse Practitioner Role

Table of Contents

Editorial Board Page

Society

Information for Readers

NAPNAP Position Statement on School-Based Health Care

NAPNAP Update