A ladder that matters: Conceptual development of a clinical ladder program for nurse practitioners and physician assistants.

ABSTRACT: Clinical ladders are professional enhancement models that encourage and reward participants for continued professional engagement and leadership development. They have the potential to affect patient care through improved provider retention, advanced and refined clinical skills, and increased engagement. Recent literature has demonstrated development and implementation of clinical ladder models for nurse practitioners (NPs) in the acute care setting. A free standing pediatric academic hospital in Florida identified the need for such a program for nurse practitioners and given its increased utilization of physician assistants, these providers were also targeted for inclusion. This new clinical ladder included development strategies appropriate and attainable for both NP and PA scopes of practice. Consistent with Benner's theory of novice to expert (1982), each advancing rung in the ladder contains more stringent criteria and additional competencies demonstrating increased engagement, learning, and leadership. As this was a development project only, future directions for the new model include implementation and evaluation of various metrics including nurse practitioner and physician assistant retention and satisfaction. This model has laid the foundation for ladder development for additional health care professions within the institution.

White Paper: Recognizing Child Trafficking as a Critical Emerging Health Threat.

Human trafficking is a pandemic human rights violation with an emerging paradigm shift that reframes an issue traditionally seen through a criminal justice lens to that of a public health crisis, particularly for children. Children and adolescents who are trafficked or are at risk for trafficking should receive evidence-based, trauma-informed, and culturally responsive care from trained health care providers (HCPs). The purpose of this article was to engage and equip pediatric HCPs to respond effectively to human trafficking in the clinical setting, improving health outcomes for affected and at-risk children. Pediatric HCPs are ideally positioned to intervene and advocate for children with health disparities and vulnerability to trafficking in a broad spectrum of care settings and to optimize equitable health outcomes.

Adults with Liver Failure in the Intensive Care Unit: A Transplant Primer for Nurses.

Liver transplant is the standard of care for treatment of many liver diseases. Patients with acute liver failure or end-stage liver disease may require intensive care management. Nurses play a vital role in the care of these patients before and immediately after transplant. Optimal patient outcomes depend on intensive care nurses being able to understand the process of liver failure and the necessary patient management during the pretransplant and early posttransplant periods. This article provides critical care nurses with an overview of liver disease and transplant for adult patients with a diagnosis of liver failure.