PDF(Pubmed)
Abstract：
BACKGROUND: The pediatric nurse practitioner (PNP) workforce was designed to improve child health equity. We aimed to systematically review the evidence on facilitators and barriers to PNP practice.
METHODS: We included empirical studies on PNP practice in the United States and excluded studies with non-identifiable PNP data. We applied Joanna Briggs Institute tools to appraise studies and applied critical interpretive synthesis principles to synthesize.
RESULTS: The final sample is 26 studies, mostly published before 2013 and observational. Prescriptive privileges, training program availability, organizational climate, and telehealth are facilitators. Mandated physician supervision, reduced pediatric curricula, geographically disparate training programs, and poor data infrastructure are barriers. The sample is limited by a moderate to high risk of bias.
CONCLUSIONS: Evidence suggests modifiable factors impact PNP practice and could have important implications for child health equity. We offer a theoretical model to guide robust research studying the PNP workforce and health equity.
METHODS: We included empirical studies on PNP practice in the United States and excluded studies with non-identifiable PNP data. We applied Joanna Briggs Institute tools to appraise studies and applied critical interpretive synthesis principles to synthesize.
RESULTS: The final sample is 26 studies, mostly published before 2013 and observational. Prescriptive privileges, training program availability, organizational climate, and telehealth are facilitators. Mandated physician supervision, reduced pediatric curricula, geographically disparate training programs, and poor data infrastructure are barriers. The sample is limited by a moderate to high risk of bias.
CONCLUSIONS: Evidence suggests modifiable factors impact PNP practice and could have important implications for child health equity. We offer a theoretical model to guide robust research studying the PNP workforce and health equity.
摘要：
背景：儿科执业护士（PNP）劳动力旨在改善儿童健康公平性。我们旨在系统地审查有关PNP实践的促进者和障碍的证据。
方法：我们纳入了美国PNP实践的实证研究，并排除了具有不可识别的PNP数据的研究。我们应用JoannaBriggs研究所的工具来评估研究，并应用关键的解释性综合原则来综合。
结果：最终样本是26项研究，主要在2013年之前出版和观察。规定特权，培训计划的可用性，组织氛围，和远程医疗是促进者。强制医生监督，减少儿科课程，地理上不同的培训计划，糟糕的数据基础设施是障碍。样本受到中度到高度偏倚风险的限制。
结论：证据表明，可改变的因素会影响PNP实践，并可能对儿童健康公平产生重要影响。我们提供了一个理论模型来指导研究PNP劳动力和健康公平的稳健研究。
方法：我们纳入了美国PNP实践的实证研究，并排除了具有不可识别的PNP数据的研究。我们应用JoannaBriggs研究所的工具来评估研究，并应用关键的解释性综合原则来综合。
结果：最终样本是26项研究，主要在2013年之前出版和观察。规定特权，培训计划的可用性，组织氛围，和远程医疗是促进者。强制医生监督，减少儿科课程，地理上不同的培训计划，糟糕的数据基础设施是障碍。样本受到中度到高度偏倚风险的限制。
结论：证据表明，可改变的因素会影响PNP实践，并可能对儿童健康公平产生重要影响。我们提供了一个理论模型来指导研究PNP劳动力和健康公平的稳健研究。
