Nursing unions: A scoping review of outcomes for employees, patients, and administrators.

Background: Nursing labor organization is consequential to many stakeholders, but collective evidence for outcomes associated with nurse unionization is lacking.

Purpose: To synthesize evidence of associations between nursing unions and nurse, patient, and system outcomes.

Methods: A scoping review.

State Differences in Children's Mental Health Care.

Objective: This study estimates and compares variation in the probability of child unmet need for mental health care and difficulties accessing care for each state in the United States. Estimates are also generated and compared for three socioeconomic and demographic subgroups nationwide: racial and ethnic group, household income, and insurance type.

Methods: Using a retrospective, cross-sectional design, this study pooled 2016-2019 National Survey of Children's Health data.

Adapting the Nurse Practitioner Primary Care Organizational Climate Questionnaire for Acute Care Nurse Practitioners.

This study adapted the Nurse Practitioner Primary Care Organizational Climate Questionnaire to measure the organizational climate of nurse practitioners in acute care settings and validated the Nurse Practitioner Acute Care Organizational Climate Questionnaire (NP-ACOCQ). We used a three-phase instrument adaptation design. In phase 1, experts assessed face and content validity.

Neighborhood-Level Social Determinants of Health and Adolescent Mental Health.

Objective: Mental health diagnoses among adolescents are increasing in prevalence. Existing literature considers associations between individual-level social determinants of health (SDOH) and adolescent mental health. Neighborhood-level SDOH can have a substantial impact on health.

Scope-of-Practice Expansions Associated with Reduced Racial Disparities in Pediatric Mental Health Care.

To examine the association between scope-of-practice (SoP) regulations and racial disparities in pediatric mental health services. We used the National Survey of Children's Health (2016-2020; n = 33,790) to examine racial disparities in unmet mental health care needs and receipt of mental health medication between states with and without SoP expansions for psychologists and nurse practitioners (NP). Our primary outcomes were (1) unmet mental health care needs and (2) receipt of mental health medication.

Experiences of Workplace Violence in Graduate Nursing Clinical Education.

Background: Exposure to workplace violence (WPV) is common in health care, and little is known about nurse practitioner (NP) students' experiences during graduate nursing clinical education.

Purpose: This study described experiences of WPV among NP students during their clinical education.

Methods: We conducted a cross-sectional, quantitative survey of a random sample of NPs licensed in Texas examining graduate nursing education experiences.

Opportunities to Diversify the Pediatric Nursing Workforce: A Focus on Male Nurses.

Introduction: Pediatric nursing has been a profession dominated by women, but patients benefit from representation of both men and women. We describe characteristics associated with male pediatric nurses and consider potential pathways to greater male pediatric nurse workforce participation.

Method: We used data from the 2018 National Sample Survey of Registered Nurses, a nationally representative survey of nurses that estimates characteristics of the workforce.

Pediatric Mental Health Care and Scope-of-Practice Expansions.

To examine the association between psychologist and nurse practitioner scope-of-practice (SoP) regulations and pediatric mental health service access. A nationally representative sample of children with mental health needs was identified using 5 years of National Survey of Children's Health (2016-2020). Utilization was measured in two ways: (1) unmet mental health care needs and (2) receipt of mental health medication.

Facilitators and Barriers to Pediatric Nurse Practitioner Practice in the United States: A Systematic Review.

Introduction: The pediatric nurse practitioner (PNP) workforce was designed to improve child health equity. We aimed to systematically review the evidence on facilitators and barriers to PNP practice.

Method: We included empirical studies on PNP practice in the United States and excluded studies with non-identifiable PNP data.

The Perspectives of Advanced Practice Provider Directors on Acute Care Nurse Practitioner Alignment and Hiring.

Demand for acute care is forecasted to grow in the United States. To meet this demand, nurse practitioners (NPs) are increasingly employed in acute care settings. Yet, there is concern about an adequate supply of acute care NPs given demand.

Advancement of research on nurse practitioners: Setting a research agenda.

Background: Primary care delivered by nurse practitioners (NPs) helps to meet the United States' growing demand for care and improves patient outcomes. Yet, barriers impede NP practice. Knowledge of these barriers is limited, hindering opportunities to eliminate them.

Career Choices and Experiences in Role Transition: A Multistate Survey of Pediatric-Focused Hospital-Based Nurse Practitioners.

Introduction: We examined factors influencing pediatric hospital-based APPs' career decisions and described the transition to practice experiences.

Method: We conducted a cross-sectional, descriptive electronic survey using a novel instrument to examine APP career decisions and transition to practice experiences among APPs in four Southeastern children's hospitals.

Results: There were 158 respondents composed of family nurse practitioners (NPs) (30%), primary care pediatric NPs (24%), and acute care pediatric NPs (18%).

Changes in Use and Access to Care for Children and Youth With Special Health Care Needs During the COVID-19 Pandemic.

Introduction: Children and youth with special health care needs (CYSHCN) are vulnerable to health care disruption, and policies were adopted to mitigate COVID-19-related disruptions. We compare CYSHCN use of and access to care in 2019 to 2020.

Method: Using the National Survey of Children's Health, we identified CYSHCN and assessed differences in health care use, unmet health care needs, frustrations accessing care, and barriers to care using multivariable logistic regression analysis.

Meeting the need for nurse practitioner clinicals: A survey of practitioners.

Background: The increase in the number of nurse practitioner (NP) students requires increased clinical practice sites and prepared preceptors.

Purpose: This study describes NPs' clinical experiences as a student and their current practices as an NP preceptor.

Methodology: A descriptive study design used a 38-item web-based survey conducted in June and July 2021.

Evaluation of the Culture of Safety and Quality in Pediatric Primary Care Practices.

Objectives: The purposes of this article were to describe the perceptions of the culture of safety in pediatric primary care and evaluate whether organizational factors and staff roles are associated with perceptions of the culture of safety.

Methods: We conducted a secondary data analysis using 2020 Agency for Healthcare Research and Quality Medical Office Survey on Patient Safety Culture to examine the culture of safety and quality in pediatric primary care practices. We used descriptive statistics and calculated differences in perceptions of patient safety and quality based on practice size, ownership, and staff roles using bivariate and logistic regressions.

Guidance for Structuring a Pediatric Intermediate Care Unit.

The purpose of this policy statement is to update the 2004 American Academy of Pediatrics clinical report and provide enhanced guidance for institutions, administrators, and providers in the development and operation of a pediatric intermediate care unit (IMCU). Since 2004, there have been significant advances in pediatric medical, surgical, and critical care that have resulted in an evolution in the acuity and complexity of children potentially requiring IMCU admission. A group of 9 clinical experts in pediatric critical care, hospital medicine, intermediate care, and surgery developed a consensus on priority topics requiring updates, reviewed the relevant evidence, and, through a series of virtual meetings, developed the document.

A Roadmap for Successful State Sepsis Regulations-Lessons From New York.

Unlabelled: New York state implemented the first state-level sepsis regulations in 2013. These regulations were associated with improved mortality, leading other states to consider similar steps. Our objective was to provide insight into New York state's sepsis policy making process, creating a roadmap for policymakers in other states considering similar regulations.

Implications of State Scope-of-Practice Regulations for Pediatric Intensive Care Unit Nurse Practitioner Roles.

Nurse practitioner (NP) advocacy efforts often focus on attaining full practice authority. While the effects of full practice authority in primary care are well described, implications for hospital-based NPs are less clear and may differ because of hospitals' team-based care and administrative structure. This study examines associations between state scope-of-practice (SSOP) and clinical roles of hospital-based pediatric intensive care unit (PICU) NPs.

Advanced Practice Provider-inclusive Staffing Models and Patient Outcomes in Pediatric Critical Care.

Background: Pediatric intensive care units (PICUs) are increasingly staffed with advanced practice providers (APPs), supplementing traditional physician staffing models.

Objectives: We evaluate the effect of APP-inclusive staffing models on clinical outcomes and resource utilization in US PICUs.

Research Design: Retrospective cohort study of children admitted to PICUs in 9 states in 2016 using the Healthcare Cost and Utilization Project's State Inpatient Databases.

Data Disaggregation: A Research Tool to Identify Health Inequities.

The U.S. population is increasingly diverse, with less than half of all children identifying as non-Hispanic White.

Economic Analysis of Mandated Protocolized Sepsis Care in New York Hospitals.

Objectives: Initial evidence suggests that state-level regulatory mandates for sepsis quality improvement are associated with decreased sepsis mortality. However, sepsis mandates require financial investments on the part of hospitals and may lead to increased spending. We evaluated the effects of the 2013 New York State sepsis regulations on the costs of care for patients hospitalized with sepsis.

Pediatric Outcomes After Regulatory Mandates for Sepsis Care.

Background: In 2013, New York introduced regulations mandating that hospitals develop pediatric-specific protocols for sepsis recognition and treatment.

Methods: We used hospital discharge data from 2011 to 2015 to compare changes in pediatric sepsis outcomes in New York and 4 control states: Florida, Massachusetts, Maryland, and New Jersey. We examined the effect of the New York regulations on 30-day in-hospital mortality using a comparative interrupted time-series approach, controlling for patient and hospital characteristics and preregulation temporal trends.

Misalignment of specialty nurse practitioners and the Consensus Model.

Nurse practitioner (NP) employment in specialty practice areas, such as subspecialty ambulatory practices and inpatient units is growing substantially. The Consensus Model provides guidelines to help states aligning NP education and certification with specialty practice area. Despite expansion of the Consensus Model, significant misalignment exists between specialty NPs' education, certification, and practice location.