Pediatric Neurocritical Care, Lucile Packard Children's Hospital Stanford, 725 Welch Rd., Palo Alto, CA, 94404, USA.
Pediatric Critical Care, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Neurocrit Care. 2024 Oct;41(2):568-575. doi: 10.1007/s12028-024-01976-6. Epub 2024 Apr 3.
Nurses are vital partners in the development of pediatric neurocritical care (PNCC) programs. Nursing expertise is acknowledged to be an integral component of high-quality specialty patient care in the field, but little guidance exists regarding educational requirements to build that expertise. We sought to obtain expert consensus from nursing professionals and physicians on curricular priorities for specialized PNCC nursing education in pediatric centers across the United States.
We used a modified Delphi study technique surveying a multidisciplinary expert panel of nursing professionals and physicians. Online surveys were distributed to 44 panelists over three rounds to achieve consensus on curricular topics deemed essential for PNCC nursing education. During each round, panelists were asked to rate topics as essential or not essential, as well as given opportunities to provide feedback and suggest changes. Feedback was shared anonymously to the panelist group throughout the process.
From 70 initial individual topics, the consensus process yielded 19 refined topics that were confirmed to be essential for a PNCC nursing curriculum by the expert panel. Discrepancies existed regarding how universally to recommend topics of advanced neuromonitoring, such as brain tissue oxygenation; specialized neurological assessments, such as the serial neurological assessment in pediatrics or National Institutes of Health Stroke Scale; and some disease-based populations. Panelists remarked that not all centers see specific diseases, and not all centers currently employ advanced neuromonitoring technologies and skills.
We report 19 widely accepted curricular priorities that can serve as a standard educational base for PNCC nursing. Developing education for nurses in PNCC will complement PNCC programs with targeted nursing expertise that extends comprehensive specialty care to the bedside. Further work is necessary to effectively execute educational certification programs, implement nursing standards in the field, and evaluate the impact of nursing expertise on patient care and outcomes.
护士是儿科神经危重症护理（PNCC）项目发展的重要合作伙伴。护理专业知识被认为是该领域高质量专科患者护理的一个组成部分，但在构建专业知识方面的教育要求方面几乎没有指导。我们试图从护理专业人员和医生那里获得美国儿科中心专门的 PNCC 护理教育课程重点的专家共识。
我们使用改良 Delphi 研究技术对护理专业人员和医生的多学科专家小组进行了调查。我们在三轮中向 44 名小组成员分发了在线调查，以就 PNCC 护理教育的基本课程主题达成共识。在每一轮中，小组成员被要求将主题评为必需或非必需，并有机会提供反馈和建议更改。在整个过程中，匿名向小组成员分享反馈。
从最初的 70 个单独主题中，共识过程产生了 19 个经过精炼的主题，这些主题被专家小组确认为 PNCC 护理课程的必要主题。关于如何普遍推荐高级神经监测主题（如脑组织氧合）、专门的神经评估（如儿科连续神经评估或 NIH 中风量表）以及一些基于疾病的人群，存在差异。小组成员指出，并非所有中心都能看到特定的疾病，并非所有中心都目前都采用先进的神经监测技术和技能。
我们报告了 19 个广泛接受的课程重点，可以作为 PNCC 护理的标准教育基础。为 PNCC 护士提供教育将通过针对特定护理专业知识的 PNCC 计划，将全面的专业护理扩展到床边。需要进一步努力来有效地执行教育认证计划、在该领域实施护理标准，并评估护理专业知识对患者护理和结果的影响。
