Pediatric Nurse Practitioners play an essential role in ensuring children’s health and well-being from birth to young adulthood. One of the most important facets of this role involves supporting each child’s transition from pediatric healthcare to adult healthcare.
The University of Texas at Arlington offers an online Master of Science (MSN) in Pediatric Primary Care Nurse Practitioner (PNP-PC) degree program focused on this breadth of pediatric nursing development. Students build expertise in working with children from birth to 21 years of age. The curriculum emphasizes fostering the healthcare management skills and collaborative relationships needed to support young adults’ transition to adult healthcare.
What Is the Healthcare Transition?
Children receive specialized pediatric healthcare tailored to individual needs as well as the various stages of child development. A pediatric healthcare team can consist of several professionals like pediatric nurse practitioners (PNPs), physician assistants (PAs), pediatricians, counselors and psychologists.
Members of a child’s pediatric healthcare team may work out of the same facility. This can help foster cohesive, integrated care, collectively ensuring each child’s physical, mental and social well-being and development.
As young adults leave their childhood home environment, they experience a shift toward independent decision-making and living circumstances, like developing autonomous control concerning their healthcare. The services they receive also shift, reflecting the changing healthcare needs of adults. Thus, as young adults transition to adulthood, they go from pediatric care to adult care, hence the concept of the healthcare transition (HCT).
Got Transition’s Six Core Elements of Healthcare Transition offers a detailed approach to this process. It begins with developing a transition care policy and guide for patients and their caregivers.
Monitoring methods are then established and used to track patients’ receipt of HCT services and progress through the process. Patients are assessed as to their HCT readiness, with key criteria including self-care skills and the ability to engage in healthcare services independently. Readiness assessment informs further transition planning involving health literacy and self-care skill development and sets the timeline for transfer to adult-centered care.
This transfer is organized and coordinated between current providers, multiple adult care providers, patients and families. It generally occurs when patients are between ages 18 and 21. The transfer of care takes place, with confirmation from all parties involved. The last step is the gathering of feedback from the patient and family concerning the HCT approach and transition supports. Patients receive further pediatric consultation as needed to ensure the effective transfer of care.
Why Is the HCT Process Important?
While a child’s pediatric care may be relatively centralized and integrated, the network of providers involved in adult-centered healthcare is often decentralized. Primary care physicians (PCPs), psychologists or therapists, specialist doctors and other providers may all work for separate facilities such as private practices, health centers, and hospitals.
As part of the HCT process, coordinating this network of decentralized adult care providers is essential to ensuring continuity in healthcare through the transition. Yet, it is also complex, requiring intensive organization and dispensation of medical records. Besides, it relies on communication between the pediatric care team and new providers, the family and the individual undergoing HCT.
Plus, each child has unique physical, mental, social and emotional needs. Hence, each child receives individualized healthcare services. For instance, a child with special needs, exceptionalities or physical disabilities may need specialized support services and care. In transitioning out of school systems and family settings that provide support to meet a child’s needs, new services and providers will need to be engaged to continue that support into adulthood.
Providing young adults with the proper information is important for a smooth transition to adult care. It will be up to them to learn how to make independent decisions about their own healthcare, find providers that meet their needs and navigate healthcare and insurance systems. Young adults can be prepared for this level of autonomy through health education and HCT readiness skill development.
What Role Do PNPs Play in HCT?
Over the course of pediatric care, PNPs develop the comprehensive understanding of a child’s healthcare needs and development integral to guiding the HCT process. The relationships PNPs build with their patients, families and healthcare providers are essential to the communication and coordination involved in HCT.
The experience children and their families have in this process will determine their level of engagement. This patient and family engagement is necessary for the HCT to be effective. PNPs play a large role in fostering this engagement through the relationships they build.
A PNP becomes a child’s trusted ally and advocate, helping the child understand the treatment. PNPs constantly assess and work to improve the child’s self-care skills, health literacy and readiness to take control of their healthcare programs.
PNPs are often de facto healthcare educators for their patients and their patients’ families. This positions PNPs to guide patients and families through the HCT process, providing support, information, explanation of transition processes and further steps to take.
Serving as the patient’s and family’s point person, PNPs are the go-to resource until the transfer to adult-centered care is completed. The continuity PNPs give to the HCT process can ensure patients transition out of pediatric care with the support systems, knowledge, self-care skills and independence needed to become healthy adults.
National Center for Biotechnology Information: The Role of Health Advocacy in Transitions from Pediatric to Adult Care for Children with Special Health Care Needs: Bridging Families, Provider and Community Services