As providers of primary care, family nurse practitioners (FNPs) need to keep their assessment skills sharp. This ability is especially critical when caring for the pediatric population, a vulnerable group at higher risk of medical errors than adults and who may experience a quick succession of developmental milestones.
The approach to pediatric care can differ substantially depending on a child’s age, growth patterns, immunization history and family history, notes the Fast Facts Handbook for Pediatric Primary Care: A Guide for Nurse Practitioners and Physician Assistants. Astute FNPs must carefully review a student’s complete history, consider the parent/caregiver-child relationship and make recommendations appropriately — making top-notch assessment skills and training critical.
What Skills Are Necessary to Conduct Thorough Pediatric Health Assessments?
From well-child visits to acute and chronic diseases, FNPs must be knowledgeable about a range of conditions, potential presentations and differential diagnoses. Interestingly, the American Association of Nurse Practitioners (AANP) says the top diagnoses treated by nurse practitioners specializing in pediatrics and primary care are abdominal pain, migraines and otitis media. However, these are relatively nonspecific complaints that may require a thorough assessment to determine the root cause and effective treatment.
Soft skills often beneficial when caring for pediatric patients include:
- Listening and observation
- Attention to detail
- Critical thinking
In addition, FNPs must also understand the technical side of performing assessments. The experience gained throughout their nursing careers provides an excellent springboard for further instruction and learning. Students enrolled in the Master of Science in Nursing (MSN) in Pediatric Primary Care Nurse Practitioner (PNP-PC) online program from The University of Texas at Arlington (UTA) complete dedicated coursework that builds upon existing assessment proficiencies and rounds out relevant hard and soft skill sets.
Courses in the program range in focus and topics, and the following are a few notable ones:
- Advanced Health Assessment and Diagnostic Reasoning expands upon the theories and clinical skills that guide comprehensive health assessments across the lifespan.
- Pediatric Assessment Lab is an intensive three-week course where students gain hands-on experience performing pediatric assessments.
- Pediatric Primary Care covers advanced concepts for managing acute, chronic and complex problems affecting pediatric patients in primary care settings.
- Clinical Practicums allow students to gain experience in the pediatric nurse practitioner role by completing 35 weeks of primary care clinical preceptorships.
Can Healthcare Technology Improve Pediatric Assessment Accuracy?
Although nurse practitioners must be confident in their pediatric assessment skills, healthcare technology offers support and decision-making tools that can improve the accuracy of these exams. Given the ubiquity of portable devices, like tablets and laptops, pediatric providers can more thoroughly document patient encounters in real-time and quickly access historical data and research. Similarly, FNPs may use medication databases, often contained within the EHR or a mobile application, to calculate and verify weight-based drug dosages and potential interactions.
The social history gathered during an assessment can significantly impact a child’s well-being and is essential to evaluating treatment options and other early interventions. For this reason, says the Office of the National Coordinator for Health Information Technology, healthcare technology designed with pediatric care in mind should have sufficient space to document a child’s entire care team, which may consist of “caregivers and guardians such as biological parents, foster parents, adoptive parents, surrogates, custodians, siblings or caseworkers.”
Technology can also help a child feel more comfortable, as it makes for a smoother encounter and assists the FNP in completing a detailed exam. For example, the blunt contact points on shot-blocking devices saturate sensory signals near an injection site and distract the child from a needle penetrating the skin.
Overall, nurse practitioners may perform several pediatric assessments each day in primary care, so maintaining these evaluative capacities should be prioritized. By developing key technical abilities and soft skills in combination with the support of healthcare technology, FNPs with advanced educational training can maximize the information gathered from pediatric assessments and provide higher quality care.