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The Institute of Pediatric Nursing: A Unified Voice

      We thank Drs. McCarthy and Sperhac for writing this editorial to inform the readership about the new Institute of Pediatric Nursing. The Editors
      Each of us as pediatric nurses, regardless of our role, setting, or population, faces barriers that impede progress toward our goal of optimum health for children. Now, a collaborative approach among multiple pediatric nursing organizations has created a strategic alliance and a priority agenda to reduce barriers and advocate for improved health care for all children.
      Pediatric nurses appreciate the impact of significant socioeconomic, disease, and disparity issues on the health of America's children Table 1. Of the 74 million children ages 0 to 17 years in the United States, 14.1 million live in poverty, an increase of 2.5 million since 2000, and 8.1 million (1 in 10) still lack health care coverage (). The United States has the second highest infant mortality rate among 30 industrialized nations. In addition, 30% of US children have health issues ranging from asthma to depression to special care needs, whereas almost one third of all US children are overweight or obese (). Everyday across the country, pediatric nurses provide health care to children, in children's hospitals and community hospitals; in primary care settings and specialty clinics; in homes, schools, and neighborhood health centers; in schools of nursing and research centers; and in partnerships with families and with a broad range of health care providers. As the largest group of pediatric health care providers, pediatric nurses serve not only as caregivers but also as change agents working tirelessly to improve children's health, as well as the communities where they live and the systems that impact them. This work continues in spite of challenges such as workforce shortages, limited resources, and increased complexity of systems and technology that may compromise the implementation of innovations and solutions on behalf of children's health.
      Table 1Socioeconomic, Disease, and Disparity Issues on the Health of America's Children
      Each Day in America
      4 children are killed by abuse or neglect.
      5 children or teens commit suicide.
      9 children or teens are killed by firearms.
      32 children or teens die from accidents.
      78 babies die before their first birthday.
      202 children are arrested for violent crime.
      377 children are arrested for drug offenses.
      964 babies are born at low birth weight.
      1210 babies are born to teen mothers.
      2060 babies are born without health insurance.
      2175 children are confirmed as abused or neglected.
      2692 babies are born into poverty.
      4435 children are arrested.
      Although the challenges of strengthening quality care to children continue to grow, the pediatric nursing workforce remains a small proportion of all nurses in the United States. Of the 3.1 million registered nurses (RNs) in the United States (Health Resources and Services Administration [HRSA] RN National Sample Survey 2004-2008), approximately 10% or 313,759 RNs are focused on the care of children who range from neonates to adolescents and young adults (
      • US Department of Health and Human Services. The Health Resources and Services Administration
      The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses.
      ). Of additional concern is the lack of advanced practice pediatric nurses (nurse practitioners and clinical nurse specialists) who are needed to meet the primary care and chronic, specialty, and acute health care needs of children. Data from the HRSA Nursing Manpower Survey 2004 to 2008 noted fewer than 33 000 pediatric advanced practice RNs available to meet the increasing demands for pediatric care and care coordination (
      • US Department of Health and Human Services. The Health Resources and Services Administration
      The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses.
      ).
      Early in 2009, the Board of Directors of the Pediatric Nursing Certification Board (PNCB) recognized the growing need for a collaborative dialogue about these issues and envisioned the need to join together multiple nursing organizations and pediatric related health care facilities representing the important role of pediatric nurses. A unique “forum” to share common concerns and discuss potential collaborations was conceived. In November 2009, PNCB convened the first Pediatric Nursing Invitational Forum, which included representatives from more than 17 pediatric nursing professional organizations and children's health care facilities. During this historic 1 1/2–day forum, more than 30 nursing leaders with backgrounds in pediatric education, practice, administration, policy, credentialing, and research identified a common purpose: the need to strengthen and secure the well-being and welfare of children and their families through the collaborative contributions of pediatric nursing. Common areas of concern across all pediatric nursing organizations that emerged include the following:
      • access to pediatric professional care;
      • advocacy;
      • care coordination;
      • pediatric nursing education;
      • safe, quality, evidence-based care.
      At this landmark 2009 event, participants identified a collaborative platform to address the 5 common areas of concern and established a leadership group to move initiatives forward. During the next 12 months, a volunteer leadership advisory team with members representing education, research, credentialing, specialty areas, hospitals, and community/primary care, in partnership with the PNCB chief executive officer and consultants, developed bylaws and articles of incorporation and completed the nonprofit incorporation of the new Institute of Pediatric Nursing (IPN).
      In November 2010, the second annual Pediatric Nursing Invitational Forum was held with more than 50 nursing leaders from 20 pediatric nursing professional organizations and children's health care facilities in attendance. Each organization presented activities that represented achievements and areas of challenge within the 5 IPN-identified areas of common concern (access; advocacy; care coordination; education; and safe, quality, evidence-based practice). Keynote speakers provided the group a national context and scan of the current environment in the 5 areas of concern. The forum facilitated significant networking, with collaborative activities emerging among subgroups and an overall strategy of collaborations among the total group. Group discussions led to the identification of specific actions that could be carried out in these areas, ranging from a recommendation for the development of an electronic communication “sharing platform” among all the organizations to more involved activities such as obtaining funding for targeted group projects, facilitated by the IPN. As the work of the IPN continues, critical support, ideas, and collaborative opportunities will emerge from the many organizations that support the pediatric nursing community. The new IPN is now poised for action. Comprehensive information and videos describing the 2009 forum and photos and commentary from the recent 2010 forum are available on the IPN Web site (www.ipedsnursing.org). Information about the IPN has been disseminated through development of a white paper summarizing the forum, press releases, journal editorials, and recent testimony and IPN representation at meetings of the Institute of Medicine's Future of Nursing Forum.
      The leadership team, now the IPN Board of Directors, has clarified the purpose, mission, processes, and desired outcomes of the IPN. The IPN Mission is to “Create a healthy future for our nation through a unified network of pediatric nursing organizations working through education, research and practice to secure child and youth well being.”
      Based on this mission, the IPN
      • is an organization of organizations;
      • provides a unified voice for pediatric nursing issues/concerns;
      • facilitates collaborative solutions among pediatric nursing organizations;
      • supports culturally sensitive family-centered care provided within communities, with an emphasis on health promotion, disease and injury prevention, and wellness and healthy development delivered by expert practitioners who are knowledgeable, competent, and skilled in the care of children and families.
      The IPN, an alliance of multiple pediatric nursing groups, is an emerging organization, identifying how it will function and what it can accomplish. The need for a unified voice of pediatric nurses was evident in the 5 areas of common concern. The 2010 Pediatric Nursing Invitational Forum further clarified the mission and its shared vision for the future of children's health care. The emerging collaborations and priority action items provided direction to the board for the next steps that will facilitate the continued growth and shared voice of IPN. Although the organizations in attendance have their own missions and strategic plans, all have a commitment to improve the health of the nation's children. Together, through the shared purpose of IPN, barriers to the achievement of those missions may be reduced so that care to all children is enhanced and improved.

      References

        • The Children's Defense Fund
        The State of America's Children 2010.
        (Retrieved from)
        • US Department of Health and Human Services. The Health Resources and Services Administration
        The Registered Nurse Population: Findings from the 2008 National Sample Survey of Registered Nurses.
        (Retrieved from:)