PNP Corner

Best practices for both hospital and ambulatory care centers include methods to encourage the continuous educational development of all members of nursing and interprofessional (IP) teams. One successful, but sometimes resisted strategy, is to engage all members of the team in planned monthly journal club luncheons in which the members review a recently published article that may impact practice management strategies.

The dilemmas and barriers that providers encounter daily in clinical practice in attempting to maintain confidentiality for their adolescent patient while simultaneously protecting the adolescent from potential harm are daunting for providers as there are no nationally recognized, evidence-based standards addressing adolescent confidentiality and privacy issues in the delivery of quality healthcare to adolescents.

Is the overwhelming problem of too many opioid and narcotic pain prescriptions related to the identification of ‘pain’ as the ‘fifth vital sign’?  Was the intention for the designation, the ‘fifth vital sign’, an expectation that individuals would be pain free during hospital stays, eg, after a surgical procedure, or after visiting ambulatory centers for an injury?

Dr. Bass’ recent article in Contemporary Pediatrics, “Personalized medicine, right drug, right patient, right time,” provides a miniature but profound view of what may be the future of pediatric healthcare: focusing on healthcare that is truly individualized through precision science in the areas of diagnosis and treatment, rather than generalized, population-based treatment guidelines.

Traditionally, first positions for graduating registered nurses (RNs) are hospital based, where many have expertise and experience in emergency management. However, when RNs attend graduate school to become primary care nurse practitioners, planning for managing emergencies in an outpatient medical office may or may not have been a part of graduate education.

Children in the foster care system are exposed early in life to adverse experiences by living within dysfunctional families and specific facts have not changed. What has changed is the recognition of the need for the healthcare system to change its care for these vulnerable children to prevent the adverse effects that traumatic stress imposes on their physical and emotional development and well-being.

Dr Bass’s article on “Factoring the Metabolic X Syndrome” in the latest issue of Contemporary Pediatrics provides us with information on the emergence of Metabolic X syndrome in the pediatric/adolescent populations, previously a syndrome seen only in adults. How can we, as nurse practitioners (NPs) prevent children from developing the symptoms for a diagnosis of Metabolic X Syndrome?

The article “National hospital initiative targets preventable injuries,” in the most recent issue of Contemporary Pediatrics, describes 35 years of impressive work by a nationwide coalition of concerned pediatricians and pediatric trauma surgeons who have championed hospital, school-based, and community-wide initiatives to reduce the prevalence and incidence of unintentional injuries in children.