Pediatric nurse practitioners: roles and scope of practice.
BACKGROUND
There are ∼ 13,000 pediatric nurse practitioners (PNPs) in the United States. PNPs have been suggested as professionals who could provide care to the growing cadre of children with chronic illnesses and expand the pool of subspecialty care providers. Little is known about current roles of PNPs in primary or subspecialty care.


OBJECTIVE
To gain a better understanding of the roles, focus of practice, professional setting, and professional responsibilities of PNPs.


METHODS
We conducted a mail survey of a random national sample of 1200 PNPs stratified according to states that license NPs to practice independently. χ(2) statistics were used to assess responses from PNPs in states that allow independent practice versus those that do not and on PNPs in primary versus specialty care.


RESULTS
The overall response rate was 82.4%. Ninety-six percent (n = 636) of the PNPs were female. More than half of all the respondents (59% [n = 391]) worked in primary care, and almost two-thirds (64% [n = 394]) did not provide care in inpatient settings. Only 11% of the PNPs in states that allow independent practice, practiced independently.


CONCLUSIONS
The majority of PNPs currently work in primary care, and most do not have any inpatient roles. It does not seem that independent PNP practices are responsible for a significant portion of pediatric visits. For those who posit that PNPs will help alleviate the currently perceived shortage of pediatric subspecialists, our findings indicate that it likely will not occur without a significant change in the PNP workforce distribution.
University of Michigan, Child Health Evaluation and Research (CHEAR) Unit, 300 North Ingalls Building, Ann Arbor, MI 48109-0456, USA. gfreed@med.umich.edu
Gary L
GL
Freed
Kelly M
KM
Dunham
Kara E
KE
Lamarand
Carol
C
Loveland-Cherry
Kristy K
KK
Martyn
D000328:Adult; D002321:Career Choice; D002648:Child; D002908:Chronic Disease / Q000451:nursing*; D003625:Data Collection; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009722:Nurse Practitioners; D024802:Nurse's Role; D010371:Pediatric Nursing; D057184:Practice Patterns, Nurses'; D011320:Primary Health Care; D017009:Professional Autonomy; D013038:Specialization; D014481:United States