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Pediatric emergent/urgent and ambulatory care: the pocket NP--a quick reference resource for ENPs.

Review of:

Shea, S.S., Hoyt, K.S, & Sanders Jordan, K. (2016), Pediatric emergent/urgent and ambulatory care: The pocket NP. New York, NY: Springer Publishing Company.

Nurse practitioners working in the fast-paced environment of emergency and urgent care have significant obstacles to effective delivery and documentation of thorough care for children. Pediatric clients may be only a portion of the population seen when not working in a dedicated pediatric service, and pediatric patients are not "little adults" for whom common health care practices with older patients are appropriate. The three authors of this handy little reference are all emergency nurse practitioners with decades of practical experience, as well as being seasoned authors. They understand emergency nurse practitioners must have readily available resources for practice. The authors note that their purpose is to provide an easy-to-use guide for pediatric care, though the focus is clearly acute illness rather than comprehensive care.

This book is easy to carry around and keep at hand. The book begins with a page for handy contact information, such as for other hospital departments and access passwords (which of course we should never write down but always do write down). Several pages of abbreviations may be standard for emergency care areas but are not all familiar to someone who is not solidly experienced in emergency care, making the reference particularly helpful to the student and new practitioner.

In addition to guides for clinical decisions about ill children, the authors provide guides for documentation. There are general templates for thorough documenting, and that follow formats used in formal education programs for new practitioners. These templates include the important negatives to document, as well as giving examples of how to communicate positive findings. The authors have also included a billing considerations chart showing how increasingly complex cases should have expanded documentation. The documentation templates should be very helpful to new practitioners or to those involved in developing electronic records for emergency/urgent care sites.

The guidelines for clinical decisions follow standard format. The guidelines are presented according to complaint and body system, beginning with skin and proceeding down the body from head to toe. Management of wounds has its own section. Under a Miscellaneous heading, the reader will find guidelines for assessment and management of pain, fever, maltreatment, syncope, seizures, diabetic ketoacidosis, sickle cell disease, hematologic and oncologic disorders, and poisoning.

Each guideline has focused history and physical examination areas, gives synopses of differential diagnoses that may be relevant to the complaint, and provides management strategies and specifics for documenting. Documentation of X-ray findings and post-procedure assessments are included where relevant. The authors include tips drawn from their expertise and "Don't Miss!" clues. Black-and-white illustrations are included throughout the book that aid in understanding the anatomy of the problem or examination techniques.

Medications and dosing regimens are included, but a more current and complete pharmacologic resource should be used for the most up-to-date recommendations. As a pediatric nurse practitioner, I was happy to see that the "wait and see" approach to management of acute otitis media is included, but dosing of amoxicillin for acute otitis media is not high enough to cover resistant pneumococcus, which is so common now.

This little resource is clearly directed at the prescribing provider in the emergency/urgent care environment, although some conditions addressed would be equally well managed in a primary care setting. Mid-level provider students and new providers would benefit most from this handy tool. An emergency department registered nurse could also find this resource helpful in anticipating the process of assessment, the patient education needs for testing, and management.

Marcia R. Gardner, PhD, RN, CPNP, CPN

Jane Cerruti Dellert, PhD, RN, CPNP, is Assistant Professor, Department of Graduate Nursing, Seton Hall University College of Nursing, South Orange, NJ.
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Author:Dellert, Jane Cerruti
Publication:Pediatric Nursing
Geographic Code:1USA
Date:May 1, 2016
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