The following article is a part of conference coverage from the National Association of Pediatric Nurse Practitioners (NAPNAP) 42nd National Conference on Pediatric Health Care, held virtually from March 24 to March 27, 2021. The team at the Clinical Advisor will be reporting on the latest news and research conducted by leading nurse practitioners in pediatrics. Check back for more from NAPNAP 2021.
Although pediatric nurse practitioners (NPs) play a vital role in transition planning in young adults with chronic illness, more than 80% of these professionals have not received specialized training in this role, according to results of a nationwide survey.1,2
In many cases, health care transition planning (HCTP) activities performed by pediatric NPs and nurses are not included in their job description, Jennifer A. Disabato, DNP, CPNP-PC, AC, associate professor at the University of Colorado College of Nursing in Aurora, and colleagues reported in a poster presented virtually at the National Association of Pediatric Nurse Practitioners Annual Meeting (NAPNAP 2021).
Adolescents and young adults with chronic illness and/or disability (CID) face numerous challenges when transitioning from pediatric to adult health care. Health care transition planning has emerged as a nursing practice priority and its importance is recognized by various national health organizations, including NAPNAP, National Institutes of Health/National Institute of Child Health and Human Development, and National Institute of Nursing Research. This survey builds on previous research by the study authors and was designed to better understand the extent that pediatric NPs and nurses are involved with HCTP in this population and what HCTP activities they provide.3,4
A study conducted by the Centers for Disease Control and Prevention also reported that only 15% of adolescents received guidance from the health care provider on the transition from adolescent to adult health care. The authors concluded that adolescents, especially those with diagnosed mental, behavioral, and developmental disorders, could benefit from receiving earlier transition planning.5
Nationwide Survey of Nurses and NPs
A total of 1814 members of the Society of Pediatric Nurses and pediatric nurse or NP certificants from the Pediatric Nursing Certification Board completed the survey. Overall, 64% of respondents reported performing transition plans for youth with CID transitioning to adult care, but only 18% reported having specialized training in this transition of care.
The most common transition of care activities performed by respondents included the following:
- Speaking with families about complex health needs (64%)
- Speaking with other health professionals about complex health needs (63%)
- Acting as health advocate for youth (61%)
- Acting as health advocate for family/caregiver (60%)
- Supporting youth in self-management (60%)
However, these transition planning activities were not included in the job descriptions of 11% to 20% of respondents. Also, few respondents (18%-28%) ranked their level of knowledge of HCTP activities as high (4 or 5 on a scale from 1 to 5).
The respondents ranked activities related to educating and supporting disease self-management and speaking with families about complex needs as having the highest level of perceived importance. Significant predictors of knowledge of HCTP activities included professional role, inclusion of transition planning in job description, and specialized HCTP training.
“Inclusion of HCTP activities in pediatric NP and pediatric nurse job descriptions and specialized interdisciplinary HCTP training related to this emerging and growing population may enhance pediatric nurses’ vital role in HCTP for youth and young adults with CID,” the researchers noted.
For more information on HCTP, Dr Disabato suggested visiting Got Transition from The National Alliance to Advance Adolescent Health as well as the Healthcare Transition Research Consortium website.
Visit Clinical Advisor’s meetings section for complete coverage of NAPNAP 2021.
1. Disabato JA, Mannino JE, Betz CL. Pediatric nurse practitioner and nursing roles in health care transition planning (HCTP): national survey findings and practice implications. Poster presented at: NAPNAP 2021; March 24-27, 2021. EP-R4.
2. Disabato JA, Mannino JE, Betz CL. Pediatric nurses’ role in health care transition planning: national survey findings and practice implications. J Pediatr Nurs. 2019;49:60-66. doi:10.1016/j.pedn.2019.08.003
3. Betz CL, Mannino JE, Disabato JA. Survey of US pediatric nurses’ role in health care transition planning: Focus on assessment of self-management abilities of youth and young adults with long-term conditions. J Child Health Care. 2020 Sep 1:1367493520953649. doi:10.1177/1367493520953649
4. Mannino JE, Disabato JA, Betz CL. The development and content validation of a self-reported instrument to explore the nurse’s role in healthcare transition planning for youth and young adults with chronic illness and/or disability (NR-HCTP). J Pediatr Nurs. 2018;43:56-61. doi:10.1016/j.pedn.2018.08.015
5. Leeb RT, Danielson ML, Bitsko RH, et al. Support for transition from adolescent to adult health care among adolescents with and without mental, behavioral, and developmental disorders – United States, 2016-2017. MMWR Morb Mortal Wkly Rep. 2020;69(34):1156-1160.