The SPN Pediatric Nursing Excellence Model: Differentiating pediatrics

Published:November 01, 2022DOI:


      • A project to develop a model of the construct of Pediatric Nursing Excellence (PNE)
      • Engaging pediatric nurses in the process of developing the PNE Model
      • The PNE Model consists of 16 concepts with definitions and a graphic depiction.
      • Potential uses of the PNE Model in various areas of pediatric nursing are discussed.


      The question of what makes an “excellent” pediatric nurse has been asked frequently by both pediatric and non-pediatric nurses for many years. Longevity in the practice setting, increased formal education in the care of children and families, positive satisfaction surveys post encounter, quantity of professional presentations and publications, and specialty certification are often listed when discussing pediatric nursing excellence. However, pediatric nursing excellence (PNE) is not well defined. Current recognition mechanisms such as clinical ladders, Magnet© and Pathways© programs, and Benner's stages of clinical competence are not specific for pediatric nursing practice. Once the characteristics of pediatric nursing excellence are determined, they can be used as the basis for identifying pediatric-specific quality indicators.
      In 2020, SPN initiated a project to define the construct of “pediatric nursing excellence”. Two years later, SPN published its Pediatric Nursing Excellence Model, consisting of a visual depiction accompanied by definitions of 16 concepts that comprise the PNE Model. This article presents the five stages of the development process, the components of a model of pediatric nursing excellence, and the potential uses of such a model.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      1. Agency for Healthcare Research and Quality (AHRQ). (2018). Care coordination.

        • Agosto P.M.
        • Barton S.
        • Hickerson K.A.
        • McCloskey M.
        • Murawski S.
        • Roberts K.E.
        Redesign of a pediatric hospital’s professional advancement program.
        Nursing Economic$. 2020; 38: 41-50
        • American Association of Colleges of Nursing (AACN)
        The essentials of baccalaureate education for professional nursing practice.
        2008: 1-62
      2. AACN Beacon award for excellence program information sheet. American Association of Critical-Care Nurses (AACN), 2019
      3. American Association of Critical-Care Nurses (AACN). (n.d.). What is nursing excellence? Retrieved August 16, 2022, from

        • American Nurses Association & Society of Pediatric Nurses (ANA & SPN)
        Scope and standards of pediatric nursing practice., Silver Spring, MD2003
        • American Nurses Association (ANA)
        Code of ethics for nurses.
        American Nurses Publishing, 2015
        • American Nurses Association, National Association of Pediatric Nurse Practitioners, & Society of Pediatric Nurses (ANA, NAPNNAP, & SPN)
        Pediatric nursing: Scope and standards of practice.
        2nd ed., Silver Spring, MD2015
        • American Nurses Credentialing Center (ANCC)
        Criteria for nursing excellence.
        American Nurses Credentialing Center, Silver Spring, MD2019
        • Benner P.
        From novice to expert.
        American Journal of Nursing. 1982; 82: 402-407
        • Betz C.L.
        Health care quality and outcome guidelines for nursing of children and families.
        Journal of Pediatric Nursing. 2005; 20: 149-152
        • Betz C.L.
        • Cowell J.M.
        • Faulkner M.S.
        • Feeg V.D.
        • Greenberg C.S.
        • Krajicek M.J.
        • Lipman T.H.
        • Lobo M.L.
        • Nehring E.M.
        • Rosenberg M.C.
        • Vessey J.A.
        Advancing the development of the guidelines for the nursing of children, adolescents, and families: 2014 revision: Process, development, and dissemination.
        Journal of Pediatric Health Care. 2016; 30: 284-288
        • Betz C.L.
        • Cowell J.M.
        • Lobo M.L.
        • Craft-Rosenberg M.
        American Academy of Nursing child and family expert panel health care quality and outcomes guidelines for nursing of children and families: Phase II.
        Nursing Outlook. 2004; 52: 311-316
        • Betz C.L.
        • Krajicek M.J.
        • Craft-Rosenberg M.
        Guidelines for nursing excellence in the care of children, youth, and families.
        2nd ed. Springer Publishing Company, New York2018
        • Burt J.
        • Rick J.
        • Blakeman T.
        • Protheroe J.
        • Roland M.
        • Bower P.
        Care plans and care planning in long term conditions: A conceptual model.
        Primary Health Care Research & Development. 2014; 15: 342-354
        • Craft-Rosenberg M.
        • Krajicek M.J.
        • Shin D.
        Report of the American Academy of Nursing child-family expert panel: Identification of quality and outcome indicators for maternal child nursing.
        Nursing Outlook. 2002; 50: 57-60
        • Curley M.A.Q.
        Synergy: The unique relationship between nurses and patients, the AACN synergy model for patient care.
        Sigma Theta Tau International, Indianapolis2007
      4. DAISY Foundation. (2022). What is the DAISY award?

        • Emich C.
        Conceptualizing collaboration in nursing.
        Nursing Forum. 2018; 53: 567-573
        • Farre A.
        • Wood V.
        • Rapley T.
        • Parr J.
        • Reape D.
        • McDonagh J.
        Developmentally appropriate healthcare for young people: A scoping study.
        Archives of Diseases of Children. 2015; 100: 144-151
        • Fawcett J.
        Thoughts about recognizing excellence in nursing.
        Nursing Science Quarterly. 2020; 33: 175-177
        • Foster R.
        The American Academy of Nursing’s guidelines for healthcare quality and outcomes: Implications for pediatric nursing practice.
        Journal for Specialists in Pediatric Nursing. 2005; 10: 99-102
        • Gralton K.S.
        • Brett S.A.
        Integrating the synergy model for patient care at children’s hospital of Wisconsin.
        Journal of Pediatric Nursing. 2012; 27: 74-81
      5. Greiner A.C. Knebel E. Health professions education: A bridge to quality. Board on Health Care Services, Committee on Health Professions Education Summit, Institute of Medicine2003
        • Harrison T.M.
        • Steward D.
        • Tucker S.
        • Fortney C.A.
        • Militello L.K.
        • Smith L.H.
        • Thrane S.
        • Tubbs-Cooley H.L.
        • Pickler R.H.
        The future of pediatric nursing science.
        Nursing Outlook. 2019; 68: 73-82
      6. Institute for Patient-and Family-Centered Care (IPFCC). (2016). Patient-and Family-Centered Care.

      7. International Consortium for Health Outcomes Measurement (ICHOM). (2019). ICHOM standard sets.

        • Jasemi M.
        • Valizadeh L.
        • Zamanzadeh V.
        • Keogh B.
        A concept analysis of holistic care by hybrid model.
        Indian Journal of Palliative Care. 2017; 23: 71-80
        • Lewandowski L.
        • Tessler M.
        Family-centered care: Putting it into action – The SPN/ANA guide to family-centered care., Washington, DC2003
        • Lewis C.P.
        ANCC recognition of professional nursing practice.
        American Nurse Today. 2019; 14: 44-47
      8. Developmentally appropriate practice: A position statement of the National Association for education of young children. National Association for Education of Young Children (NAEYC), 2020
        • Nowell L.S.
        • Norris J.M.
        • White D.E.
        • Moules N.J.
        Thematic analysis: Striving to meet the trustworthiness criteria.
        International Journal of Qualitative Methods. 2017; 16 ( 1-13
      9. Nursing Database of Nursing Quality Indicators (NDNQI). (2010).

        • Pabico C.
        • Graystone R.
        Comparing pathway to excellence® and magnet recognition® programs.
        American Nurse Today. 2018; 13 (46, 48, 50)
        • Porter M.E.
        What is value in health care?.
        The New England Journal of Medicine. 2010; 363: 2477-2481
      10. Quality and Safety Education for Nurses (QSEN) Institute. (2020). QSEN competencies.

        • Reich W.
        • Hilliard D.
        • Gartland M.
        Revising a clinical ladder program to increase nurse participation.
        American Nurse Journal. 2020; 15: 46-49
        • Seattle Children'’s Department of Nursing Practice, Professional Development, and Innovation & the Center for Diversity and Health Equity
        Definition for equity/diversity/inclusion. Authors.
      11. Society of Pediatric Nurses (SPN). (2017a). SPN Pediatric Residency Core Competencies.

      12. Society of Pediatric Nurses (SPN). (2017b). SPN Pre-Licensure Core Competencies.

        • Squires J.E.
        • Aloisio L.D.
        • Grimshaw J.M.
        • et al.
        Attributes of context relevant to healthcare professionals’ use of research evidence in clinical practice: A multi-study analysis.
        Implementation Science. 2019; 14: 1-14
      13. World Health Organization (WHO). (2012). The World Health Organization Quality of Life user manual.