Adolescent Medicine. Policy makers must ensure that all practitioners are prepared, by virtue of education and training, to provide the services authorized in their scope of practice in a safe, effective, and economical manner.”. AAP chapters should encourage, recruit, and train their members to serve as advocates of optimal pediatric health care in state-level policy initiatives concerning nonphysician scope of practice. Recent studies have shown that even in states which allow independent practice for NPs, fewer than 15% of pediatric NPs actually choose to practice independently.4 Regardless of the state in which they practice, the vast majority of pediatric NPs choose to practice under the supervision of general pediatricians, pediatric medical subspecialists, or pediatric surgical specialists. ^ Pediatric Nursing Scope And Standards Of Practice ^ Uploaded By Louis L Amour, with input from numerous nurses they developed pediatric nursing scope and standards of practice 2nd edition it is a comprehensive delineation of the competent level of practice and professional performance common to and expected from pediatric Increases in the duration of education or the final degree (eg, a DNP or PhD in Nursing) will not achieve educational parity with physicians. Furthermore, the AAP maintains that to ensure safe and effective care, all members of the health care team must be required to demonstrate adequate education, training, skills, and competencies in pediatric health within their scope of practice, and all members of the health care team must provide care that is consistent with their education, training, and licensure. This article requires a subscription to view the full text. For nonphysician clinicians who practice independently of a physician, public policy should require both exclusive professional responsibility for the care they provide and adequate liability insurance to allow for appropriate financial remedy for adverse settlements or decisions. The care provided by NPs can vary considerably on the basis of the laws in the state in which they practice. When patient care responsibilities must be shared by multiple providers, the pediatrician should assume primary responsibility for managing the full range of health care services to ensure continuity of care within the child’s medical home.1 For some children, a general pediatrician and a pediatric medical subspecialist or surgical specialist may decide to comanage care. As leader of the pediatric health care team, the physician oversees the delivery of care and, when appropriate, delegates patient care responsibilities to nurse practitioners (NPs), physician assistants (PAs), and other valued members of the heath care team. Provide consultations within the scope of his/her privileges Render any care in a life-threatening emergency Initiate and manage mechanical ventilation for 24 hours SEDATION Local anesthesia GENERAL PEDIATRIC MEDICINE Abscess drainage Arterial blood gas Arterial line placement Bladder catheterization CPR/bag and mask ventilation In comparison, with 4 years of medical school and 3 years of pediatric residency at a minimum, the pediatrician has invested between 12 000 and 14 000 clinical hours at the completion of basic pediatric training alone. In this team-based model of pediatric care, the physician assumes overall responsibility for the care of the patient. Because a greater supply of NPs in a state does not necessarily lead to an equitable distribution to areas that are underserved, the AAP does not support changes in scope of practice for NPs in these areas and believes it is ill-advised to create a system of care based on independent practice without any supervision or oversight by a physician. Available at: Cronenwett L, Dzau V. In: Culliton B, Russell S, eds. Pediatricians should serve as advocates for optimal pediatric care in state legislatures, public policy forums, and the media and should pursue opportunities to resolve scope of practice conflicts outside state legislatures. Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired. Therefore, the AAP believes that pediatricians and NPs are not interchangeable in the delivery of pediatric health care. This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. The AAP is involved in the development of educational standards and national certification for PAs through appointed representatives on the boards of the Accreditation Review Commission on Education for the Physician Assistant and the National Commission on Certification of Physician Assistants. Because physicians can be held accountable for clinicians acting under their supervision, a pediatrician should consider potential professional or medical liability issues before establishing a supervisory relationship. A recent study of the geographic distribution of pediatric NPs found that the majority of states have fewer than 25 pediatric NPs per 100 000 children and that a state’s independent practice laws are not related to its density of pediatric NPs.11 In 2010, almost 85% of all NPs reported practicing in urban areas.12 Furthermore, a recent study from the University of Washington Rural Health Research Center found no statistically significant link between states that allow NPs greater practice autonomy and higher rates of NP practice in rural areas.

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