Importance Of Pediatric Advanced Life Support

Emergencies occur anytime, anywhere, which is why being prepared is something that most people should exemplify. The American Heart Association took this belief by heart, which had served as the basis of their program called Pediatric Advanced Life Support or PALS. AHA originally developed PALS classes in 1983 as response for the needs of resuscitation guidelines and trainings that would aid health care professionals in providing care for patients especially for children. Since then, PALS provide health care professionals the skills and knowledge to properly respond and treat critically ill patients suffering from cardiac arrest or other cardiopulmonary emergencies, specifically infants and children, whether in or out of the hospital.

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How is Importance Of Pediatric Advanced Life Support

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PALS is a program that follows simulated clinical scenarios and learning stations to actively encourage students to learn and practice life-saving skills individually, as a part of a team and as team leaders. PALS give emphasis on the importance of basic life support CPR for the survival of patients, integration of advanced pediatric life support intervention as well as the importance of team communication, interaction and cooperation during resuscitation. The realistic simulation involved in PALS course reinforce major health care concepts that include basic life support care proficiency, cardiac arrest management, recognition and early management initiation for peri-conditions, algorithms, ischemic chest pain and coronary syndrome identification and treatment, effective team interaction, and recognition of other life-threatening conditions in order to administer initial care.

To get PALS certification, individuals are required to take PALS course. This could be done in two different ways either through AHA approved online PALS providers or through attending PALS classes in medical schools or hospitals. If you are looking to complete your PALS certification immediately, you could go online and complete your PALS course from your computer at your own pace. If you are more adept to learning in a classroom setting, it would be more preferable to attend in medical schools or hospitals that offer PALS course.

PALs classes have a standardized curriculum wherein students attend a classroom-based education led by an instructor with video aid and skills conducted throughout and are provided with materials for continuing education that is strongly based from AHA's "assess-categorize-decide-act." PALS course lasts for 14 hours long and most providers offer it for two intensive days. On the process of the course, an AHA PALS instructor is the one who facilitate the discussion around simulations and video-based lessons and students are required to participate in 12 core clinical cases. They are also expected to complete and pass a written examination before they receive their certification.

PALS certification is intentionally designed to be participated by health care professionals that includes family physicians, pediatricians, emergency physicians, physician assistants, nurses, paramedics, nurse practitioners, respiratory therapists and other health care providers that directly administer advanced life support during pediatric emergencies. For these individuals to participate in the course, it is necessary that they have completed an American Heart Association basic life support (BLS) health care provider course or American Red Cross BLS course for professional rescuers, PALS pharmacology and knowledge in ECG interpretation. They also have to complete the pre-course material given to them prior to the first day of classes so that they would not be rescheduled. Once they passed the PALS course and examination, they would be given the PALS provider course completion card which is valid for two years.

Of course, pediatric advanced life support is not only beneficial for health care practitioners; it is also advantageous for patients especially for critically ill or injured children. Accordingly, the development of PALS has been shown to consistently increase the survival rate of patients suffering from cardiac arrest or other cardiopulmonary emergencies, who were attended by PALS certified health care practitioners in pre-hospital settings. Overall, the development of PALS is relatively useful both for health care professionals and patients during emergency situations. If you're a health care professional who wish to further improve your clinical practice, it is about time to receive PALS certification in order to provide the best medical care you could give to the community.

As a healthcare professional, it always pays to be prepared especially during emergency cases whether in or out of the hospital. One of the most important means to be equipped with the skills and knowledge about proper patient care is by attending pediatric advanced life support or PALS classes to be able to further improve one's life-saving skills. PALS is especially tailored for physicians, pediatricians, nurses paramedics and other healthcare providers involved in direct advanced life support during pediatric emergencies.

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Current Issues For Advanced Practice Nurses

Today people are living longer than ever. The discovery of new technology, innovative medicines, science, and research all play apart of that. An increase in aging population is one of the most dramatic demographic trends in the world today. Many elders present many complex diseases and require complex care and disease management. The challenge also presents many opportunities in the healthcare field and a shortage of providers in rural areas. The roles for advanced practice nursing (APN) have been introduced since the late nineteenth century till the present (Hamric, Spross, and Hanson, 2009, p. 3). These roles include certified registered nurse anesthetists (CRNAs), certified nurse-midwives (CNMs), clinical nurse specialists (CNSs), and nurse practitioners (NPs) (Hamric, Spross, and Hanson, 2009, p. 3). Building credibility and defining practice of APN roles did not firmly establish until in late 1970s (Hamric, Spross, and Hanson, 2009, p. 17).

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How is Current Issues For Advanced Practice Nurses

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In 1992, the American Nurse Association (ANA) established Healthcare Reform which focused on restructuring the United States healthcare system to reduce costs and improve access to care (Hamric, Spross, and Hanson, 2009, p. 23). Today APNs face many challenges as they strive to be recognized by members of the society. The current issues faced by APNs are discussed below and this information is based on Advanced Practice Nursing: An Integrative Approach (4th ed.).

The Key Issues
The identified key issues are education, scope of practice, specialty practice, reimbursement, titling, prescriptive authority, legal status, regulation, and credentialing issues. The similarities among these issues are all embedded in regulatory languages which make it difficult for APNs to benefit from development of nursing role. The differences occur when one failed to collaborate and to address these above issues as a whole and to promote collaborative relationships with other regulated health disciplines both at the national and state level. And, indeed these issues are still importance to the practice of advanced practice nurses.

Three Chosen Issues
The three chosen issues are scope of practice/specialty practice, reimbursement, and prescriptive authority. Like never before, the profession for APNs has emerged into different era which presents many different opportunities and challenges for newcomers. Today APNs can be found working anywhere from the family practice, cardiology office, urgent care always to emergency medicine. As a new graduate APN, the role can present many challenges and obstacles especially when she or he tries to adjust to the new role while attempting to comply with several clinical practice guidelines.

Even though the title of APN is recognized as a valuable asset to the community and other healthcare team member, many of them are still struggled to get reimbursed properly. The holistic caring approach provided by APNs is not inferior to the medical model provided by physicians. The education requirement for both professions will be soon about the same especially with the new requirement of a doctoral degree for APNs. This is the reason APNs still debate for equal pay for equal service when care is compared between both health providers.

After reading Advanced Practice Nursing: An Integrative Approach (4th ed.) page 606 and 607, the reality becomes clear that APNs have to prove so much in order to gain sole authority in scope of practice. The Board of Medicine continues to find ways to limit the scope of practice for APNs. According to Lugo, O'Grady, Hodnicki, & Hanson (2007), 23 states possess sole authority from the board of nursing; whereas other states possess joint authority with the board of medicine, the board of pharmacy, or both (Hamric, Spross, and Hanson, 2009, p. 606). The outcome of this disagreement affects the role and practice of APNs greatly especially when they attempt to provide the best care possible in a timely manner.

Top Two Issues
The chosen top two issues are reimbursement and prescriptive authority. As a new graduate APN, she or he must get educated well about different payment options such Medicare and Medicaid, third party payers, and more to ensure proper reimbursement. The second strategy is to encourage schools throughout the country to incorporate this valuable lesson as part of the standard curriculum. The nursing profession as a whole should continue to flight aggressively for equal service for equal pay because nursing profession should not be assumed as inferior to other independent health providers despite different styles of caring approach. As an individual APN, one must continue the education to doctorial level in order to try to resolve the unfair disadvantage of prescriptive authority across the nation. The second strategy is APNs should continue to promote the recognition of APN as safe and cost-effective alternative provider throughout the healthcare systems.

Regulatory Barriers
The current regulatory barriers for APNs are prescriptive authority, reimbursement schemes, nursing education, and scope of practice and titling. The variance in board regulations from state to state is a problem facing APNs who highly mobile (Hamric, Spross, and Hanson, 2009, p. 610). Even though prescriptive authority exists over the years and becomes fairly standard for APN prescribers, but the requirements still vary from state to state (Hamric, Spross, and Hanson, 2009, p. 607). For those APNs who love to travel and work at another state to make sure to check the scope of practice for that state as it varies significantly (Hamric, Spross, and Hanson, 2009, p. 607). The professional nursing organizations and the National Council of State Boards of Nursing (NCSBN) have been working on a new regulatory model for APNs in order to promote some uniformity on credentialing and licensure (Hamric, Spross, and Hanson, 2009, p. 610). A system of mutual regulatory recognition between states is needed and remains to be done.

Conclusion
Even though most of the hard work was done to promote the path to independency and uniformity for advanced practice nursing, but several issues remain to be solved especially in the areas of credentialing and regulation. Many nursing organization is working aggressively to put a new regulatory model in place to promote a system of mutual regulatory recognition. The field in advanced practice nursing is evolving and changing rapidly, especially in the areas of advanced practice nursing specialties. As a result of this complex change, policymakers and regulators face many challenges and obstacles to ensure development of broad-based practice standards. At the same time this challenge also presents many new opportunities for advancing practice nursing; thus APNs continue to prove themselves as safe and cost-effective providers to the members of society and to move forward to a better professional future.

Reference

Hamric, A. B., Spross, J. A., & Hanson, C. M. (2009). Advanced practice nursing: An integrative approach (4th ed.). St. Louis, MO: Elsevier.

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