Advanced Practice Professional Development, Stanford Medicine Children's Health, Palo Alto, California.
DNP Executive Track, Johns Hopkins School of Nursing, Baltimore, Maryland.
J Am Assoc Nurse Pract. 2024 Sep 1;36(9):504-511. doi: 10.1097/JXX.0000000000001038.
An increased demand for pediatric-focused advanced practice providers (APPs) exists to address the health care needs of children with medical complexity. Postlicensure advanced practice fellowship programs have been developed to help improve novice provider transition to practice, reducing attrition.
The objectives of this integrative review are to (1) identify outcome measurements of pediatric-focused advanced practice fellowship programs and (2) evaluate the outcome measures to guide future implications for practice.
A systematic integrative literature review was conducted in accordance with the Preferred Reporting Items for Systemic Reviews and Meta-Analyses. PubMed, CINAHL, Embase, and Google Scholar were searched in August and September 2022. Articles met inclusion criteria if they included new graduate APPs, reported the intervention of a pediatric fellowship program, and shared outcome measurements. Studies were excluded if they did not directly report on fellowship program outcome measures. Thirteen studies met inclusion criteria and were summarized and appraised for quality using the Johns Hopkins Evidence-Based Practice Model.
Four themes from the literature included the favorable impact of advanced practice fellowship programs on (a) job satisfaction, (b) retention, (c) clinical and professional performance, and (d) financial outcomes. Variable strategies were used to measure outcomes across programs.
Postlicensure pediatric-focused advanced practice fellowship programs seem to improve retention and job satisfaction, increase provider confidence, and bring a favorable return on investment for the organization. Future work should include investment in developing validated, standardized assessment tools to support future development of these programs in the pediatric population.
为满足患有复杂疾病的儿童的医疗保健需求,对专注于儿科的高级执业医师(APP)的需求不断增加。获得许可后的高级实践专科培训计划已经开发出来,以帮助提高新手提供者的实践过渡,减少人员流失。
本次综合审查的目的是:(1)确定专注于儿科的高级实践专科培训计划的结果测量;(2)评估结果测量,以指导未来的实践影响。
根据系统评价和荟萃分析的首选报告项目,进行了系统的综合文献审查。于 2022 年 8 月和 9 月在 PubMed、CINAHL、Embase 和 Google Scholar 进行了搜索。如果文章包括新毕业的 APP,报告了儿科专科培训计划的干预措施,并分享了结果测量,则符合纳入标准。如果研究没有直接报告专科培训计划的结果测量,则将其排除在外。共有 13 项研究符合纳入标准,并使用约翰霍普金斯循证实践模型对其进行了总结和质量评估。
文献中有四个主题,包括高级实践专科培训计划对(a)工作满意度、(b)保留率、(c)临床和专业表现以及(d)财务结果的有利影响。各计划使用不同的策略来衡量结果。
获得许可后的专注于儿科的高级实践专科培训计划似乎可以提高保留率和工作满意度,增强提供者的信心,并为组织带来有利的投资回报。未来的工作应包括投资开发经过验证的标准化评估工具,以支持在儿科人群中发展这些计划。