research statement for pediatric nursing

Pediatric Nursing Research Topics for Students: A Comprehensive Guide

This article was written in collaboration with Christine T. and ChatGPT, our little helper developed by OpenAI.

Pediatric nursing is a rewarding and specialized field that focuses on the care of infants, children, and adolescents. Research in pediatric nursing plays a crucial role in advancing knowledge, improving patient outcomes, and informing evidence-based practice. This article aims to provide a comprehensive guide on pediatric nursing research topics for students, offering examples and tips to help you select the perfect topic for your project.

Common Areas of Pediatric Nursing Research

Pediatric nursing research encompasses a wide range of topics aimed at improving the health and well-being of children. Find below some of the most common areas of research.

Neonatal and Infant Care

This area of research focuses on the health and development of newborns and infants, as well as the interventions and strategies that can enhance their well-being. Studies may investigate the impact of skin-to-skin contact on neonatal outcomes, the role of breastfeeding in infant nutrition and health, and the efficacy of various interventions for premature infants, such as music therapy, to reduce stress and improve development.

Topic Examples to Explore:

• The impact of skin-to-skin contact on neonatal bonding and breastfeeding success
• The role of kangaroo care in improving outcomes for preterm infants
• Strategies for managing neonatal abstinence syndrome in infants exposed to opioids in utero
• The effectiveness of different neonatal resuscitation techniques
• The impact of maternal mental health on infant development and attachment
• The role of probiotics in preventing necrotizing enterocolitis in preterm infants
• The benefits of human milk fortifiers for premature infants
• The long-term effects of neonatal intensive care unit (NICU) environments on infant development
• The impact of neonatal jaundice on infant health and development
• The role of early intervention in improving outcomes for infants with congenital heart disease
• The benefits of non-invasive ventilation techniques in neonatal care
• The impact of delayed cord clamping on infant health
• The role of family-centered care in the NICU
• The effectiveness of developmental care interventions in the NICU
• The impact of neonatal hypoglycemia on long-term outcomes
• The role of therapeutic hypothermia in the management of hypoxic-ischemic encephalopathy
• The impact of various feeding methods on growth and development in preterm infants
• The effectiveness of music therapy for reducing stress and promoting development in the NICU
• The role of antibiotics in preventing early-onset neonatal sepsis
• The impact of antenatal corticosteroids on neonatal respiratory outcomes
• The effectiveness of non-pharmacological interventions for neonatal pain relief
• The role of parental involvement in infant care in the NICU
• The impact of noise and light reduction strategies on infant outcomes in the NICU

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Child Development and Growth

Research in this area examines the various factors that influence a child’s physical, cognitive, and emotional development. Topics may include the effects of parenting styles on children’s behavior, the role of nutrition in growth and development, and the impact of early intervention programs on cognitive and language development.

• The effects of parenting styles on children’s cognitive and emotional development
• The impact of screen time on children’s language and social skills
• The role of play in promoting cognitive, social, and emotional development
• The impact of early literacy interventions on children’s reading skills and academic achievement
• The effects of childhood nutrition on cognitive development and school performance
• The role of sleep in children’s growth and development
• The impact of early intervention programs on language development in children with hearing loss
• The effectiveness of physical activity interventions for promoting motor development in children with disabilities
• Bridging the gap: tackling maternal and child health disparities between developed and underdeveloped countries
• The role of attachment and bonding in early childhood development
• The impact of adverse childhood experiences on cognitive and emotional development
• The role of cultural factors in shaping children’s development and socialization
• The effects of poverty on children’s cognitive, social, and emotional development
• The impact of preschool and kindergarten programs on children’s school readiness
• The role of creativity in promoting cognitive and emotional development in children
• The impact of bilingualism on children’s cognitive development and academic achievement
• The effects of parental involvement on children’s academic success and social development
• The role of nutrition in preventing stunted growth and promoting healthy development
• The impact of early exposure to music on children’s cognitive and social development
• The effectiveness of interventions for promoting resilience in children exposed to trauma
• The role of sports and physical activity in promoting children’s mental health and well-being
• The impact of bullying on children’s social and emotional development
• The role of peer relationships in children’s social and emotional development
• The effects of parental mental health on children’s development and well-being

Pediatric Mental Health

With increasing awareness of mental health issues in children, research in this area is crucial to understanding and addressing the mental health needs of young patients. Studies may explore the prevalence and risk factors of various mental health disorders, such as autism, ADHD, and depression, as well as the effectiveness of interventions, such as cognitive-behavioral therapy and psychopharmacological treatments.

• The prevalence and impact of anxiety disorders in children and adolescents
• The effectiveness of cognitive-behavioral therapy for treating childhood depression
• The role of early intervention in preventing and treating childhood trauma and post-traumatic stress disorder (PTSD)
• The impact of bullying on the mental health of children and adolescents
• The relationship between autism spectrum disorders and mental health challenges in children
• The effectiveness of play therapy in addressing emotional and behavioral issues in children
• The role of family therapy in promoting positive mental health outcomes for children and adolescents
• The impact of substance abuse on the mental health of adolescents
• The effectiveness of school-based mental health interventions for children and adolescents
• The role of peer support in promoting positive mental health outcomes in children and adolescents
• The impact of social media on the mental health of children and adolescents
• The effectiveness of mindfulness-based interventions for promoting mental health in children and adolescents
• The role of resilience in protecting children’s mental health
• The impact of adverse childhood experiences on the development of mental health disorders in children and adolescents
• The effectiveness of early intervention programs for children at risk of developing mental health disorders
• The role of cultural factors in shaping children’s mental health and well-being
• The impact of parenting styles on children’s mental health outcomes
• The effectiveness of pharmacological interventions for treating mental health disorders in children and adolescents
• The role of sleep in promoting mental health and well-being in children and adolescents
• The impact of chronic illness on the mental health of children and adolescents
• The effectiveness of art therapy in promoting mental health and well-being in children and adolescents
• The role of sports and physical activity in promoting mental health and well-being in children and adolescents
• The impact of parental mental health on children’s mental health and well-being

Childhood Chronic Illness

Research in this area investigates the management, treatment, and long-term outcomes of chronic conditions in children, such as asthma, diabetes, and cystic fibrosis. Studies may examine the effectiveness of different management strategies, the role of family support in disease management, and the impact of these conditions on children’s quality of life.

• The impact of chronic illness on children’s growth and development
• The role of family-centered care in the management of childhood chronic illnesses
• The effectiveness of transition programs for adolescents with chronic illnesses moving to adult healthcare services
• The impact of school-based interventions for children with chronic illnesses
• The role of psychosocial interventions in promoting positive outcomes for children with chronic illnesses
• The impact of chronic illness on children’s mental health and well-being
• The effectiveness of telehealth interventions for managing childhood chronic illnesses
• The role of nutrition in the management of chronic illnesses in children
• The impact of chronic illness on children’s academic achievement and school performance
• The role of parent and caregiver support in managing childhood chronic illnesses
• The effectiveness of pain management strategies for children with chronic illnesses
• The impact of chronic illness on children’s social and emotional development
• The role of peer support in promoting positive outcomes for children with chronic illnesses
• The effectiveness of exercise and physical activity interventions for children with chronic illnesses
• The impact of chronic illness on the family system and sibling relationships
• The role of cultural factors in shaping the experiences of children with chronic illnesses
• The effectiveness of community-based programs for supporting children with chronic illnesses
• The impact of chronic illness on children’s quality of life
• The role of healthcare coordination in the management of childhood chronic illnesses
• The effectiveness of integrative medicine approaches for managing chronic illnesses in children
• The impact of chronic illness on children’s self-concept and identity development
• The role of health literacy in promoting positive outcomes for children with chronic illnesses
• The effectiveness of technology-based interventions for managing childhood chronic illnesses

Pediatric Pain Management

Pain is a common issue faced by children in various healthcare settings, and research in this area seeks to better understand and manage pain in pediatric patients. Topics may include the assessment of pain in children, the use of pharmacological and non-pharmacological interventions for pain relief, and the impact of pain management strategies on children’s recovery and well-being.

• The effectiveness of non-pharmacological interventions for managing pediatric pain
• The role of pharmacological interventions in pediatric pain management
• The impact of pain on children’s growth, development, and well-being
• The effectiveness of alternative and complementary therapies in pediatric pain management
• The role of family-centered care in the management of pediatric pain
• The impact of pediatric pain on children’s mental health and quality of life
• The effectiveness of cognitive-behavioral strategies for managing pediatric pain
• The role of age-appropriate pain assessment tools in guiding pediatric pain management
• Pediatric oncology: working towards better treatment through evidence-based research
• The impact of chronic pain on children’s school performance and social functioning
• The role of healthcare professionals in providing education and support for pediatric pain management
• The effectiveness of interdisciplinary pain management teams for children with complex pain needs
• The impact of pediatric pain on the family system and sibling relationships
• The role of cultural factors in shaping pediatric pain management practices
• The effectiveness of technology-based interventions for managing pediatric pain
• The impact of pediatric pain on children’s self-concept and identity development
• The role of pain management in promoting positive outcomes for children undergoing surgery or medical procedures
• The effectiveness of integrative medicine approaches for managing pediatric pain
• The impact of pain on children’s sleep and daily functioning
• The role of preventive strategies in reducing pediatric pain associated with common childhood conditions
• The effectiveness of early intervention programs for children at risk of developing chronic pain
• The impact of pain on children’s physical activity levels and participation in sports
• The role of peer support in promoting positive outcomes for children with chronic pain
• The effectiveness of parent and caregiver support interventions for managing pediatric pain

Health Promotion and Disease Prevention

This area of research aims to identify and implement strategies to promote health and prevent illness in children. Topics may include the effectiveness of vaccination programs, the role of physical activity and nutrition in childhood obesity prevention, and the impact of health education programs on children’s health behaviors.

• The role of childhood immunizations in preventing infectious diseases
• The impact of school-based health promotion programs on children’s health behaviors and outcomes
• The effectiveness of nutrition education interventions for promoting healthy eating habits in children
• The role of physical activity interventions in preventing childhood obesity and promoting healthy growth
• The impact of dental health promotion programs on children’s oral health outcomes
• The effectiveness of sun safety education for preventing skin cancer in children and adolescents
• Pediatric nursing: caring for children and fostering a healthy future
• The role of parental involvement in promoting health behaviors and preventing disease in children
• The impact of community-based health promotion programs on children’s health and well-being
• The effectiveness of early intervention programs for preventing and managing childhood asthma
• The role of mental health promotion interventions in preventing mental health disorders in children and adolescents
• The impact of anti-bullying programs on children’s mental health and well-being
• The effectiveness of substance abuse prevention programs for children and adolescents
• The role of sexual health education in preventing sexually transmitted infections and promoting healthy relationships in adolescents
• The impact of environmental interventions on reducing children’s exposure to allergens and pollutants
• The effectiveness of sleep hygiene education for promoting healthy sleep habits in children and adolescents
• The role of injury prevention programs in reducing the incidence of childhood injuries and accidents
• The impact of tobacco, alcohol, and drug prevention programs on children’s health and well-being
• The effectiveness of child passenger safety education for preventing motor vehicle-related injuries in children
• The role of health literacy interventions in promoting healthy behaviors and preventing disease in children and adolescents
• Combating health care-associated infections: a community-based approach
• The impact of culturally sensitive health promotion programs on improving health outcomes for diverse pediatric populations
• The effectiveness of school-based mental health promotion programs for preventing suicide in children and adolescents
• The role of family-centered health promotion interventions in supporting overall child health and well-being
• The impact of public health policies on reducing health disparities and promoting health equity among children and adolescents

These topic examples should provide a comprehensive starting point for students interested in pediatric nursing research. By exploring various aspects of pediatric health, students can contribute to the growing body of knowledge and help improve care for children and their families.

Tips for selecting a pediatric nursing research topic

Choosing the right pediatric nursing research topic is an essential step in ensuring a successful research project. Here are some tips to help you select a topic that will be both engaging and valuable:

• Consider Your Interests:

Selecting a research topic that genuinely interests you will make the entire research process more enjoyable and motivating. Passion for your topic can lead to more in-depth research and better quality work.

• Scope and Feasibility:

Make sure your chosen topic is not too broad or too narrow. A topic with a manageable scope will allow you to explore it in-depth without becoming overwhelmed with information. Ensure that you have access to the necessary resources, such as literature, research tools, and study participants, to conduct your research effectively.

Choose a topic that is relevant to current pediatric nursing practice and has the potential to contribute to the field. Research that addresses current challenges and gaps in knowledge will be more likely to make a meaningful impact.

• Consult with Mentors and Colleagues:

Discuss your potential research topics with your professors, mentors, or fellow students to gain insights and feedback. They may provide valuable suggestions or help you refine your topic further.

• Review Existing Literature:

Conduct a thorough literature review to identify existing research in your area of interest. This will help you understand the current state of knowledge and identify gaps or areas that need further exploration.

• Ethical Considerations:

Ensure that your research topic adheres to ethical guidelines and does not pose any harm to your study participants or their families. Obtain any necessary ethical approvals from your institution or relevant governing bodies.

• Practical Implications:

Consider the potential practical implications of your research topic. Will your findings contribute to improving pediatric nursing practice or lead to the development of new interventions or policies?

• Align with Your Career Goals:

If possible, choose a research topic that aligns with your long-term career goals. This can help build a foundation for your professional development and establish expertise in your chosen area.

• Stay Updated with Current Trends:

Keep up-to-date with the latest trends and developments in pediatric nursing to ensure your research topic remains relevant and timely. Subscribe to relevant journals, attend conferences, and engage with professional organizations to stay informed.

• Be Flexible:

Remember that it’s okay to modify or refine your research topic as you progress. Be open to feedback and new ideas, and don’t be afraid to pivot your focus if necessary.

By following these tips, you can select a pediatric nursing research topic that is both engaging and valuable, contributing to the advancement of the field and your personal growth as a researcher.

Selecting a pediatric nursing research topic is an essential step in the research process. By exploring various areas of pediatric nursing and considering a wide range of topic examples, you can find the perfect subject for your project. Remember to choose a topic that interests you, is relevant and feasible, and consult with experts to ensure a successful research experience.

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40+ Research Topics on Pediatric Nursing Students

Carla johnson.

• August 24, 2023
• Essay Topics and Ideas

Pediatric nursing is a pivotal branch of healthcare, offering specialized care to infants, children, and adolescents. This area requires distinct skills, knowledge, and empathy to address this vulnerable group’s healthcare needs effectively. For nursing students aspiring to specialize in pediatric nursing, it’s vital to grasp the nuances of this field. This article delves into pediatric nursing, explores significant PICOT questions, and suggests evidence-based practice projects, nursing capstone projects, research paper topics, research questions, and essay ideas that can enrich your comprehension and readiness in pediatric nursing.

What You'll Learn

Understanding the Essence of Pediatric Nursing

Pediatric nursing involves caring for patients from infancy to adolescence, focusing on their physical, emotional, and developmental needs. It necessitates a thorough understanding of growth and developmental milestones, family dynamics, and interventions suitable for different age groups. Pediatric nurses are pivotal in advocating for their young patients, administering medications , monitoring vital signs, and supporting families through challenging medical situations.

10 PICOT Questions in Pediatric Nursing

• Population: Children with asthma; Intervention: Personalized asthma action plan; Comparison: Standardized care without personalized plans; Outcome: Reduced hospital admissions; Timeframe: 1 year.
• Population: Preterm infants; Intervention: Skin-to-skin contact (kangaroo care); Comparison: Traditional incubator care; Outcome: Enhanced weight gain and improved vital signs; Timeframe: 6 weeks.
• Population: Adolescents with type 1 diabetes; Intervention: Mobile app for glucose monitoring; Comparison: Conventional glucose monitoring methods; Outcome: Improved blood sugar control; Timeframe: 3 months.
• Population: Pediatric oncology patients ; Intervention: Play therapy incorporation; Comparison: Standard supportive care; Outcome: Enhanced emotional well-being and reduced anxiety; Timeframe: Throughout treatment.
• Population: Children undergoing vaccination; Intervention: Distraction techniques during vaccination; Comparison: No specific distraction techniques; Outcome: Decreased pain perception and reduced anxiety; Timeframe: Per vaccination visit.
• Population: Infants with neonatal abstinence syndrome; Intervention: Non-pharmacological comfort measures; Comparison: Pharmacological treatment alone; Outcome: Shortened withdrawal symptoms duration; Timeframe: Until discharge.
• Population: Children undergoing minor surgeries ; Intervention: Preoperative preparation programs; Comparison: Standard preoperative information; Outcome: Reduced preoperative anxiety and increased cooperation; Timeframe: Before surgery.
• Population: Pediatric patients with cystic fibrosis; Intervention: Structured physical activity program; Comparison: No structured program; Outcome: Improved lung function and exercise tolerance; Timeframe: 3 months.
• Population: Children with autism spectrum disorder (ASD); Intervention: Sensory-friendly interventions; Comparison: Conventional healthcare environments; Outcome: Reduced distress and improved cooperation; Timeframe: Per healthcare visit.
• Population: Pediatric patients receiving chemotherapy; Intervention: Antiemetic medications prior to chemotherapy; Comparison: Antiemetics after chemotherapy ; Outcome: Decreased incidence and severity of chemotherapy-induced nausea and vomiting; Timeframe: During chemotherapy cycles.

Evidence-Based Practice (EBP) Project Ideas in Pediatric Nursing

• Assessing the effectiveness of pain management techniques in pediatric patients.
• Investigating the impact of family-centered care on pediatric patient outcomes.
• Implementing strategies to enhance medication adherence in adolescents with chronic conditions.
• Evaluating the use of telehealth for pediatric follow-up appointments.
• Studying the benefits of music therapy in reducing anxiety among hospitalized children.

Nursing Capstone Project Suggestions in Pediatric Nursing

• Designing an informative program for parents of children with asthma.
• Developing a protocol for early recognition and intervention in pediatric sepsis cases.
• Creating a guide for transitioning adolescents with special healthcare needs to adult care.
• Designing a simulation-based training program for pediatric nurses to improve emergency response skills.
• Establishing guidelines for pain assessment and management in non-verbal pediatric patients.

Nursing Research Topics in Pediatric Nursing

• Impact of chronic illness on the psychosocial development of school-age children .
• Prevalence and consequences of bullying among pediatric patients with chronic conditions.
• Role of pediatric nurses in advocating for children’s rights in healthcare settings.
• Long-term effects of neonatal intensive care unit (NICU) stays on preterm infants’ cognitive development.
• Challenges and strategies for providing culturally sensitive care to pediatric immigrant populations.

5 Research Questions for Pediatric Nursing

• How does parental involvement influence pediatric patient outcomes in chronic illness management?
• What are the barriers to effective pain management in pediatric patients and how can they be addressed?
• What is the impact of pediatric obesity on the development of chronic diseases in adulthood?
• How do pediatric nurses contribute to fostering a sense of normalcy and routine for children in hospital settings?
• What are parents’ experiences caring for children with rare genetic disorders , and how can healthcare providers support them?

Essay Topic Ideas & Examples in Pediatric Nursing

• The Role of Pediatric Nurses in Easing the Hospital Experience for Children.
• Ethical Considerations in Pediatric End-of-Life Care.
• The Importance of Family-Centered Care in Pediatric Nursing.
• Exploring the Challenges and Rewards of Pediatric Home Healthcare.
• Promoting Immunizations : Strategies for Overcoming Vaccine Hesitancy in Pediatric Patients.

Stepping into the realm of pediatric nursing opens doors to both challenges and rewards. As nursing students, you can shape healthcare’s future by dedicating yourselves to the youngest patients’ well-being. Engaging with thoughtful research topics in pediatric nursing, PICOT questions, delving into evidence-based projects, and exploring impactful research and essay topics arms you with the skills needed for compassionate and effective pediatric care. As you continue on this educational journey, remember that seeking guidance and assistance is a part of growth. If you ever require support, consider exploring our professional writing services that can help convey your insights and findings effectively.

Frequently Asked Questions (FAQs)

• What is the role of a pediatric nurse?

 A pediatric nurse specializes in providing medical care to infants, children, and adolescents. They administer medications, monitor vital signs, educate families, and create a comfortable and safe environment for their young patients.

• What is the difference between a nurse and a pediatric nurse?

While both nurses and pediatric nurses provide medical care, pediatric nurses specifically focus on the unique needs of children and adolescents . They possess specialized knowledge in child development, growth milestones, and age-appropriate interventions.

• What are the topics in pediatric nursing?

Pediatric nursing covers a wide range of topics, including growth and development assessment, family-centered care, pediatric illnesses, injury prevention, pediatric medication administration, and ethical considerations in pediatric care.

• What are the principles of pediatric nursing?

The principles of pediatric nursing include providing family-centered care, promoting growth and development, ensuring a safe and supportive environment, tailoring interventions to meet the needs of each child, and maintaining open communication with patients and their families.

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• Member Network

The National Association of Pediatric Nurse Practitioners (NAPNAP) is committed to identifying and providing opportunities for the implementation, dissemination and evaluation of research-based care by pediatric nurse practitioners (PNPs) and their fellow pediatric-focused advanced practice registered nurses (APRNs). With a very active research committee and an evolving Research Agenda , NAPNAP continues to meet the needs of nurse researchers while expanding opportunities to improve children’s health.

Accessing Members for Research

We understand that our members and other healthcare providers rely on the expert opinions and experience our members can offer to improve the quality of available research data. We limit access to our full membership to research proposals designed by experienced investigators only and vetted by our Research Committee. A completed  Research Mailing List Request Form and application fee are required to begin the review and approval process. The review process can take up to four weeks for final approval. NOTE: There is a temporary moratorium on research requests until August. Please check back for more information in early August.

All NAPNAP student member research requests require a faculty mentor or experienced researcher to be on the investigative team. Biographical information (NIH-type biosketch) for the faculty mentor must also be included in the application. We do not accept applications from nonmember students. Only well designed research, quality improvement or evidence-based projects will be considered for email distribution to the student’s chapter upon review and approval by the association’s Research Committee and the current chapter president. Student members may not request access to our full membership and cannot engage the NAPNAP full membership by listing their faculty advisor as the Principal Investigator (PI).

The research committee suggests that student investigators review established guidelines for conducting internet surveys and research and that DNP students review the American Association of Colleges of Nursing (AACN) The Essentials of Doctoral Education for Advanced Nursing Practice for their scholarly change project.

Members who apply must be the PI or co-PI and cannot apply on behalf of the PI or co-PI if that individual is not a National Association of Pediatric Nurse Practitioners member. Please do not circumvent the research committee review process by posting a message/link for your unapproved research survey project on a chapter or SIG e-community or Open Forum in TeamPeds Member Network. NAPNAP reserves the right to remove any posts about research that have not been approved by the Research Committee. 

Submit your proposal

• Access to the NAPNAP membership or any subgroup for research purposes is generally reserved to only NAPNAP members for nursing-related research. Access may be permitted to non-members by special permission from the Research Chair.
• All research requests are reviewed by the NAPNAP Research Committee.
• NAPNAP may limit the number of research requests to NAPNAP members each quarter.
• The NAPNAP Research Access Request form must be submitted online and we must receive the application fee in order to process the request.
• If approved, the researcher is required to share the results with NAPNAP’s Research Committee after the data analysis is complete.
• The researcher must acknowledge the NAPNAP membership as a data source in any publications developed from the survey.
• School/health care agency affiliation and department
• Name of faculty advisor, if applicant is a student
• Bio-sketch of the principal investigator (NIH format)
• Proof of IRB approval (required to process the application)
• Proposed timeline for the study and anticipated date for blast email distribution
• Description of how NAPNAP will be acknowledged in the final research summary
• Formatted abstract of 250 words or less with following required headings: background and significance, purpose/aims, methods, expected impact, plans for dissemination (see descriptions for abstracts for research studies and evidence-based projects below)
• Draft of email body copy or cover letter that will accompany the research survey link (advisor’s name and contact information must be included in the email for student member requests) Please note: emails cannot have attachments.
• Rationale and evidence to support the reason for conducting the research, quality improvement or evidence-based project.
• Sample of all surveys to be distributed, including proof of reliability and validity of surveys
• Signed acknowledgement agreeing to the terms of the request
• Signed faculty endorsement, if applicant is a student

Please format research study abstracts with:

• No more than three pages, not including not including citations (APA or AMA).
• Single line spacing. 
• One inch all around margin.
• Times New Roman 11-point font.

Please structure research study abstracts to include:

• Background and significance of study. This section includes the major research (problem) area and the specific issue(s) being addressed by the study. It provides a brief synthesis of the literature, underscoring what is known about the problem and the gap or issue that your study is addressing. This section also states how the proposed study aligns with one of NAPNAP’s research priorities and the potential contribution of the study to your field.
• Purpose /aims of the study. Clearly state the purpose of the study, including the specific aims to be accomplished.
• Methods. This section details the research design, the setting, sampling method(s), sample size, and inclusion and exclusion criteria, intervention (if applicable), data collection procedures, study measures and their reliability and validity (for quantitative studies), and data analysis plan.
• Expected impact of the study.
• Plans for dissemination of the outcomes of the study. Name of the journal to which the manuscript will be sent.
• Reference page for all citations. This page is not included in the 3-page limit for the proposal narrative.

Please format evidence-based project abstracts with:

Please structure evidence-based project abstracts to include:

• Background and significance of study. This section includes the major research (problem) area and the specific issue(s) being addressed by the study. It provides a brief synthesis of the literature, underscoring what is known about the problem that your project is addressing. This section also states how the proposed study aligns with one of NAPNAP’s research priorities and the potential contribution of the study to your field.
• PICOT question or the equivalent (e g. PIPOH, PECODR, PESICO, ECLIPSE, SPICE). Clearly state the purpose of the study, including the specific aims to be accomplished.
• Appraisal of the evidence. This section should include a synthesis of the method used to appraise the evidence with a summary statement of the appraisal that indicates there is adequate evidence to suggest a change.
• Clinical expertise and patient values- This section indicates how this will be integrated into the project.
• Expected impact of the study-This section should address how this will be implemented in the population of interest and how its effectiveness will be evaluated.
• Significance of the project being addressed.
• Investigators are well suited for the project.
• Does the project utilize innovation related to concepts, approaches, methodologies, tools or interventions?
• Is the project approach a well reasoned strategy to accomplish goals and outcomes?
• Will the environment or conditions for the planned project contribute to the probability of success?

Non-refundable review fees

• NAPNAP member and student member: $50
• Nonmember: $100

Approved researchers are entitled to one National Association of Pediatric Nurse Practitioners generated email, with or without survey link, to the full association membership to promote an approved research survey. NAPNAP does not send out survey reminders.

• NAPNAP member: $500
• Non-member individual: $650
• Organization: $1,300

If you have any questions, please contact Alexandra Rojas at [email protected] or 917-746-8293. 

Below are several research resources to assist new researchers and those who are looking to learn more about research opportunities.

Research Resources

All persons who are responsible for the design, conduct, data analysis or reporting of research that involves human subjects must complete Human Subject Research Protection Training. Thereafter, a refresher course must be completed every two years. If you have never participated in a human subject tutorial or you are due to complete a refresher course, please visit HRSA’s Protecting Human Subjects Training .

The National Institutes of Health (NIH) and its individual institutes/centers offer an array of frequently asked questions (and answers) in response to inquiries on policies and programs affecting the grants process. Bookmark this page for future reference and monitor for updates.

Checkout the NAPNAP Foundation website to see if there is a research grant or scholarship opportunity available for you.

Evidence based practice is ranked by how the evidence is collected. The following is an example of a hierarchy system:

Level 1: Systematic reviews of randomized and non-randomized clinical trials Level 2: Single randomized and non-randomized clinical trials Level 3: Systematic review of correlational and observational studies Level 4: Single correlational and observational studies Level 5: Systematic review of descriptive, qualitative and physiologic studies Level 6: Single descriptive, qualitative, and physiologic studies Level 7: Opinions from authorities, and expert committees

Level 1 is the best resource to use when looking for evidence-based practice.

Reference: Polit, D. F., & Beck, C. T. (2008) Nursing research: generating and assessing evidence for nursing practice Eighth Edition. Lippincott Williams & Wilkins. Philadelphia, Pa.

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Department of Nursing & Clinical Care Services Research

The Center for Pediatric Nursing Research and Evidence-Based Practice at Children's Hospital of Philadelphia has been making significant contributions to pediatric nursing science since 2006.

While medical research tends to focus on discovery and cure, nursing research focuses on building the scientific foundation for clinical practice, symptom management, and preventing illness through screening and education. The goal of nursing research and evidence-based practice is to improve care and outcomes for patients and their families from birth through young adulthood.

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The Relationships Amongst Pediatric Nurses' Work Environments, Work Attitudes, and Experiences of Burnout

Laura buckley.

1 Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada

2 Hospital for Sick Children, Toronto, ON, Canada

Whitney Berta

3 Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada

Kristin Cleverley

4 Margaret and Wallace McCain Center for Child, Youth and Family Mental Health, Centre for Addiction and Mental Health, Toronto, ON, Canada

Kimberley Widger

Associated data.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Background: Pediatric nurses care for some of the most vulnerable patients in our healthcare system. Research on health care provider organizational behavior shows that the quality of care nurses provide is directly related to their well-being, influenced by Burnout and job stress, in the workplace. However, most of the research conducted on nursing populations neglects to separately study nurses who care for children. In a resource limited system where health care provider well-being is recognized as a priority, it is important for administrators to understand the environmental and attitudinal work factors most influential to pediatric nurse work outcomes in order to target optimization strategies. The aim of the study was to identify which modifiable work environment factors, e.g., [Incivility, Perceived Organizational Support, Quality of Work-life] make the greatest contribution to the work outcome of Burnout (i.e., Personal Accomplishment, Emotional Exhaustion, Depersonalization) in pediatric nurses.

Methods: A cross-sectional survey design was used at a large quaternary care pediatric hospital in Toronto, Canada. We administered a survey to a convenience sample of all registered nurses with >3 months experience in the Pediatric, Cardiac, and Neonatal Intensive Care Units from January 2021–March 2021. Path analysis was used to test our proposed model which was specified a priori based on a review of the literature.

Results: 143 nurses completed the survey. Path analysis of the tested model resulted in good fit. Quality of Work-life had the largest direct effect on Work Engagement (β = 0.582, S.E. = 0.111, p < 0.001). Work Engagement had the largest direct effect on Personal Accomplishment (β = 0.68, S.E. = 0.53, p < 0.001). Quality of Work-life had the largest indirect effect on Personal Accomplishment (β = 0.4, S.E. = 0.65, p < 0.001), Emotional Exhaustion (β = −0.33, S.E. = 0.87, p < 0.001), and Depersonalization (β =−0.17, S.E. = 0.41, p = 0.006), respectively. Work Engagement had the largest total effect on Personal Accomplishment (β = 0.68, S.E. = 0.64, p < 0.001) and the third largest total effect on Emotional Exhaustion (β = −0.57, S.E. = 0.83, p < 0.001). Quality of Work-life had the second largest total effect on Work Engagement (β = 0.58, S.E. = 0.11, p < 0.001) indicating that Quality of Work-life is mediated through Work Engagement for its effect on Burnout.

Conclusions: Our results indicate work environment and work attitude factors that can provide organizational leadership with a targeted focus to reduce pediatric critical care nurse Burnout, and thus improve provider well-being, in a resource limited system.

Pediatric nurses care for some of the most vulnerable patients in our healthcare system. These nurses skillfully manage the highly specialized care of children and the complex family dynamics that are inherent to the work ( 1 ). Pediatric nurse well-being in the workplace has been shown to be directly and positively related to nurses' attitudes about engaging with patients and families ( 2 ), and the quality of care provided ( 3 – 6 ). Pediatric nurses are a separate population from nurses who care for adults because of the specialized nature of providing care to children. Children are typically seen as a vulnerable population, and along with this, there is a high potential for empathetic engagement and inherent complexities in the relationships with families ( 7 , 8 ). More specifically, pediatric/neonatal critical care nurses care for the most severely ill and injured children at the highest risk of death ( 9 ). As the stakes for this patient population are arguably the highest in the hospital, stressors of the work environment are enhanced; the care needs are highly complex and the stress to the families adds additional challenges ( 10 , 11 ). Pediatric/neonatal critical care nurses are a subspecialty within a specialty. A supply-demand issue ensues as these nurses cannot be easily replaced or supplemented. Thus they are continually asked to do more (care for more patients, run more technology) with less (less time, resources, support) ( 1 ). Much of the organizational behavior research conducted to date on nursing populations has focused on general adult care nurses and excluded studying nurses who care for children ( 12 , 13 ), particularly in pediatric critical care settings.

Work outcomes refer to occupational performance factors that are influenced by work attitudes and the work environment ( 14 ). The current study focuses on the work outcome of Burnout as it is one of the most established organizational behavior concepts, with over 40 years of literature available on the topic across numerous industries ( 15 ). Maslach and Jackson (1981) define Burnout by three components; Emotional Exhaustion, Depersonalization, and lack of Personal Accomplishment ( 16 ). Emotional Exhaustion refers to nurses feeling emotionally drained from their work; Depersonalization is the development of cynicism, particularly toward patients; and lack of Personal Accomplishment refers to nurses' feelings of dissatisfaction with the care they are providing ( 16 ). Nurse Burnout impacts at the level of the provider, the patient, and the organization ( 17 ). Burnout is positively associated with nurses' intent to leave their jobs ( 18 ), decreased quality of life ( 19 ), and negatively associated with the safety of the work environment ( 3 , 4 ).

Nurses working in critical care commonly experience Burnout, with rates as high as 73% for Emotional Exhaustion, 60% for a lack of Personal Accomplishment, and 48% noting Depersonalization ( 20 ). Most of the currently available literature on pediatric nurse work outcomes, such as Burnout, focus on factors like race, marital status, or the experience of death in the workplace ( 21 – 23 ) or on high cost/low yield factors like nurses' personality traits ( 22 ). The former set of factors are non-modifiable and cannot be feasibly changed (e.g., race), while high cost/low yield factors are technically modifiable but it would not be fiscally or temporally responsible to try and impact (e.g., personality traits) ( 24 ). So while it is beneficial to be aware of the impact of these factors, they are not ideal targets for efficient modification by health care organizations. In a health care climate where resources are limited, it is important for administrators to know which environmental and attitudinal work factors make the greatest contribution to pediatric nurse work outcomes to target their optimization strategies in the most cost-effective way.

Our study began with a review of the literature on what is known about pediatric nurse Burnout ( 17 ). From there, an additional search of the literature was undertaken to investigate factors that impact Burnout in the broader health care population. Using this data and the framework of the Theory of Reasoned Action we proposed a conceptual model. Figure 1 illustrates the proposed conceptual model where the pediatric nursing work environment influences work outcomes through work attitudes, thus influencing work outcomes directly.

The relationship between factors of the work environment, work attitudes, and the work outcomes of Burnout.

Factors Related to Burnout

Work environment, incivility in the workplace.

Workplace Incivility is defined as; “low intensity behaviors that are rude, lack consideration of others, in violation of workplace norms for respect, where the intent to harm is ambiguous” ( 25 ). These behaviors serve as a pre-cursor for an exchange, or spiral, of coercive behavior.

Quality of Work Life

Sirgy et al. define quality of work life (QWL) as; “employee satisfaction with a variety of needs through resources, activities, and outcomes stemming from participation in the workplace. Thus, satisfaction from workplace experiences contributes to job satisfaction and satisfaction in other life domains. Satisfaction in the major life domains (e.g., work life, family life, home life, leisure life) contributes directly to satisfaction with overall life” ( 26 ).

Perceived Organizational Support

Perceived organizational support (POS) is defined by the extent to which the employee perceives “the organization values their contributions and cares about their well-being” ( 27 ). POS is inversely related to nurse Burnout ( 27 – 29 ); POS is positively related to Work Engagement in nurses ( 30 ); and POS is inversely related to nurses' intent to leave ( 31 – 33 ).

Work Attitudes

Work engagement.

Schaufeli, Bakker, & Salanova (2006) define Work Engagement as; “a positive, fulfilling work-related state of mind that is characterized by vigor, dedication, and absorption. To be able to increase nurses' engagement with their patients and families we must think about possible interventions in the same light. Highly engaged nurses are essential for ethical, safe, and comprehensive care ( 34 ). Work Engagement may be challenging to directly modify, but work outcomes can be influenced through more easily modifiable factors of the work environment ( 14 ). Similar to work environment factors, pediatric nurses have not been separately studied in the nursing Work Engagement literature.

Study Objectives

• 1) To test a model of modifiable work environment features and attitudes in relation to the work-related outcome of Burnout in a sample of pediatric critical care nurses.
• 2) To rank the modifiable work environment factors based on their relationship with Burnout among pediatric critical care nurses.

This study used a cross-sectional survey design to test a model of the relationships between organizational and attitudinal factors and Burnout in a convenience sample of nurses at a large quaternary care pediatric hospital in Toronto, Canada. The study was approved by the Research Ethics Board (#1000072502) at the Hospital for Sick Children.

Study Setting

The study took place in a 300-bed tertiary care hospital with a 41-bed critical care unit and a 38-bed neonatal intensive care unit in Toronto, Canada. A total of 443 Registered Nurses (RNs) work in the Cardiac Critical Care Unit (CCCU), Pediatric Critical Care Unit (PICU) and the Neonatal Intensive Care Unit (NICU) combined.

Sample and Recruitment

Inclusion criteria required that nurses had worked in the PICU, CCCU, or NICU for >3 months. Nurses undergoing orientation were excluded. All nurses in this organization are Registered Nurses (RNs). Nurses on leave (medical, parental, or otherwise) were excluded from participation as they were not actively working on the unit and not contactable via the hospital email server. All nurses working on these units were contacted via email for participation in the study. QR codes linking to the survey were also advertised on posters throughout the units. Surveys were completed and submitted automatically and anonymously online through REDCap Software ( 35 ). Data collection was conducted from January 6, 2021 to March 22, 2021. Of note, this data collection period was during the Coronavirus disease 2019 (COVID-19) pandemic. For context, participants were asked if they have cared for a COVID-19 positive patient or patient under investigation for COVID-19. Participant consent was implied by survey submission. Participants were offered a $5 coffee card as a thank you for their participation.

Data Collection Tools

The survey was made up of established instruments, previously used with nurses, that had good psychometric properties. Demographic information was also collected, along with a final open-ended question for nurses to include any other thoughts on the topic.

Maslach Burnout Inventory

Burnout was measured using the Maslach Burnout Inventory for Human Services Survey for Medical Personnel [MBI-HSS(MP)] with subscales for Depersonalization, Emotional Exhaustion, and Personal Accomplishment. Each subscale's items are scored on a Likert scale from 0 to 6, indicating the frequency that the item applies in the providers experience ranging from with 0 indicating “never” to 6 indicating a frequency of “everyday” ( 36 ).

Utrecht Work Engagement Scale

Work Engagement was measured by the Utrecht Work Engagement Scale shortened 9-item version (UWES-9). [All items are measured on a 7-point Likert scale (0 = never–6 = always) and Work Engagement scoring categories include “very high”, “high”, “average”, “low” and “very low” ( 37 )].

Work Environment Features

Workplace incivility scale.

The Workplace Incivility Scale (WIS), created by Cortina et al. was selected because it is a 7-item tool and measures a single construct of Workplace Incivility with an Cronbach's alpha = 0.89 and demonstrated validity ( 38 ). The tool is scored on a 7-point Likert scale where respondents self-report how often they experience instances of Workplace Incivility on a scale from 0 = never to 6 = daily ( 38 ).

The Survey of Perceived Organizational Support

The Survey of Perceived Organizational Support shortened 8-item tool uses a 7-point Likert scale (1 = strongly disagree to 7 = strongly agree) ( 39 ).

Quality of Work Life Measure

The Quality of Work Life Measure, developed by Sirgy et al. in 2001, combines both needs satisfaction and spillover theories within the 7-factor, 16 item tool with response options on a 7-point Likert scale (1 = very untrue to 7 = very true) ( 26 ).

Where multiple options or versions of tools were available, we selected the shortest version if there were similar psychometric properties to reduce the overall survey length. (Cronbach's alpha was calculated for each data collection tool; all had acceptable reliability with a Cronbach's alpha >0.7 Data collection tools and their psychometric properties for this sample are in Table 1 ).

Data collection tools and psychometric properties.

Sample demographics and scale scores were summarized using descriptive statistics including means, standard deviations (SD), counts, and proportions as appropriate for the type of data and scoring guidelines for the scales. In addition, a correlation matrix was estimated to determine the relationship between each of the variables used in the path model.

Analysis Objective 1

Path analysis was used to test the model ( Figure 1 ) of the relationships amongst modifiable work environment features, work attitudes and Burnout among pediatric critical care nurses. Path analysis is a component of Structural Equation Modeling (SEM); a simple case that does not include latent variables. Path analysis is most appropriate for our study as our model does not contain latent variables, therefore no measurement model is needed. Three subscales of Burnout were included in the model: Emotional Exhaustion, Depersonalization, Personal Accomplishment. Quality of Work-life, Perceived Organizational Support and Civility were the exogeneous variables, and Work Engagement was modeled to mediate the relationship between the exogenous variables and the outcome. In addition, a path for the direct effect of Perceived Organizational Support on Burnout was tested ( Figure 1 ). STATA (Version 15) was used to conduct the path analysis and effect sizes were calculated ( 40 ). Indirect effects were calculated using bootstrapping. Acceptable model fit was indicated by a non-significant χ 2 value, a comparative fit index (CDI) >0.90, a Tucker-Lewis index (TLI) 0.0.90, a root mean square standard error of approximation (RMSEA) <0.05 ( 41 ). Missing values were addressed using full information maximum likelihood estimation (FIML).

Objective 2

Modifiable work environment factors were ranked (by their correlation coefficient) based on their contribution to explaining Burnout among pediatric critical care nurses ( 42 ).

Sample Size

Minimum sample size for our study was calculated using the N:q rule, there were q = 7 parameters that require estimates. The ratio of 10:1 was used, indicating a minimum sample size of n = 70 ( 41 ). In order to improve the trustworthiness of the results, we chose to use a ratio of 15:1, for a minimum sample size of n = 105 in order to adequately power the analysis.

Response Rate

The survey link was distributed to 443 nurses in the PICU/NICU/CCCU. The distribution of respondents was 44.8% from PICU, 37.1% from NICU, and 17.5% from CCCU. Of the 158 surveys opened, 15 had no data thus were excluded, and 143 were fully or partially completed for a response rate of 32.3%. Surveys that had any complete instruments were used in the calculation of mean scores. Only surveys that had all instruments completed were used for the path model ( n = 117). Surveys with missing data were analyzed for any commonalities. Distributions for years of experience, FTE, and highest degree achieved were all similar distribution to the fully completed survey sample. NICU incomplete surveys were slightly higher amongst the incomplete surveys, perhaps indicating a higher level of interruptions during completion. At baseline, NICU nurses carry a higher patient load (more 2:1 assignments) than the other two units.

Demographic Characteristics

The majority of respondents worked full time (>0.8 Full-time equivalent) and completed a bachelor's degree as their highest degree held. Our sample was fairly evenly distributed by nurses of different years of experience. The majority of our sample had also taken care of a COVID-19 positive patient ( Table 2 ).

Respondent characteristics ( n = 143).

Pediatric Intensive Care Unit (PICU), Cardiac Critical Care Unit (CCCU), Neonatal Intensive Care Unit (NICU) .

A summary of each of the mean scores for each of the tools used in the path analysis can be found in Table 3 . The mean Emotional Exhaustion score was 24.6 with 40% scoring high level of Emotional Exhaustion. The mean Depersonalization score was 9.1 with 44.6% scoring a high level of Depersonalization. The mean Personal Accomplishment score is 32.8 with 47.7% scoring a high level of Personal Accomplishment ( Table 4 ). The correlations between Work Engagement, Quality of Work-life, Workplace Incivility, Emotional Exhaustion, Depersonalization, and Personal Accomplishment were all significant ( Table 5 ).

Summary data of Work Environment and Work Engagement scores.

Burnout subscale scores by category.

Number of respondents, Pearson correlations, scale means and standard deviations (n = 117) .

Objective 1: Results of Path Analysis

Path analysis of the tested model resulted in good fit, as demonstrated by a non-significant (χ 2 (6) = 10.6, p = 0.1015), Root mean squared error of approximation (RMSEA) = 0.08, Comparative Fit Index (CFI) = 0.90, Tucker Lewis Index (TLI) 0.93, and CD = 0.33. Our model accounts for 27% of the variance in Work Engagement scores, 44% of the variance in Emotional Exhaustion scores, 16% of the variance in Depersonalization scores, and 46% of the variance in Personal Accomplishment scores. The coefficient of determination for the entire model is low (CD = 0.33) which is common for social science based research ( 43 ). Figure 2 presents the significant standardized coefficients from the path analysis.

Conceptualized framework with standard coefficients from path analysis. WISAVG, Workplace IncivilityScore Average; QWLAVG, Quality of Work-life Average; POSAVG, Perceived Organizational Support Average; UWESAVG, Utrecht Workplace Engagement Survey Average; EE, Emotional Exhaustion; DP, Depersonalization; PA, Personal Accomplishment.

Work Outcomes

Emotional Exhaustion is strongly inversely associated with Work Engagement (β = −0.570, p < 0.001) and moderately inversely associated with Perceived Organizational Support (β = −0.226, p = 0.003). Depersonalization is moderately inversely associated with Work Engagement (β = −0.290, p < 0.001) and Perceived Organizational Support (β = −0.200, p = 0.028) Personal Accomplishment is strongly associated with Work Engagement (0.680, p < 0.001) and not statistically significantly associated with Perceived Organizational Support (β = −0.034, p = 0.668). The subcomponents of Burnout are weakly associated with each other ( Figure 2 ).

Workplace Incivility is not associated with Work Engagement (β = 0.090, p = 0.333). Quality of Work-life is strongly positively associated with Work Engagement (β = 0.580, p < 0.001) Perceived Organizational Support is not associated with Work Engagement (β = −0.053, p = 0.593) ( Figure 2 ).

Direct Effects of Variables on Burnout

Quality of Work-life had a statistically significant direct positive association with Work Engagement. Both Work Engagement and Perceived Organizational support had significant direct effect on Emotional Exhaustion and Depersonalization. Work Engagement had a significant direct effect on Personal Accomplishment ( Table 6 ).

Direct effects with standardized coefficients.

Numbers that are bold also indicate top ranked numbers (just to make them stand out) .

Mediating Role of Work Engagement

Quality of Work-life impacted each of the relationships between the organizational factors and all three subcomponents of Burnout through the mediation of Work Engagement. Quality of Work-life has a statistically significant indirect effect on Emotional Exhaustion through Work Engagement of β = −0.332, z = −4.47, p < 0.001. Quality of Work-life has a statistically significant indirect effect on Depersonalization through Work Engagement of β = −0.170, z = −2.77, p = 0.006. Quality of Work-life has a statistically significant indirect effect on Personal Accomplishment through Work Engagement of β = 0.397, z = 4.73 p < 0.001. Workplace Incivility and Perceived Organizational Support did not have any statistically significant indirect effect on the subcomponents of Burnout mediated by Work Engagement ( Table 7 ).

Indirect effects with standardized coefficients.

Objective 2: Ranking of Variables

Based on the net value of the standardized coefficients representing the total effects, the strength of the relationships amongst the variables included in the path analysis rank in the following order from strongest to weakest: (1) Work Engagement and Personal Accomplishment, (2) Quality of Work-life and Work Engagement, (3) Work Engagement and Emotional Exhaustion, (4) Quality of Work-life and Personal Accomplishment, (5) Quality of Work-life and Emotional Exhaustion, and (6) Perceived Organizational Support and Emotional Exhaustion ( Table 8 ).

Total effects with standardized coefficients.

We tested a model of the relationships amongst modifiable environmental and attitudinal factors and Burnout, and ranked the strength of the relationship in order to guide managers and leaders on how to better support nursing staff. Our model had good fit, supporting the hypothesized relationships between the work environment, work attitudes and work outcomes assessed.

Direct Effects of Work Environment on Burnout

We observed a significant positive relationship between Quality of Work-life and Work Engagement, a relationship that has been supported in previous work on registered nurses ( 44 ). By addressing elements of work-life such as physical needs (e.g., compensation, time off, health benefits) and esteem and actualization needs (e.g., relationships, skill development, and the realization of one's potential) organizations can directly impact Work Engagement. Not only does this improve the well-being of clinicians, but their enhanced well-being has also been shown to improve patient care as well as increase hospital revenues ( 45 ). This is also in congruence with the Job-Demands Resources model (JD-R) that states greater job demands (stress) and lack of resources (defined as factors similar to those of Quality of Work-life) results in greater Burnout and the inverse results in greater Work Engagement ( 46 ).

Additionally, we found that Work Engagement has significant negative/inverse relationships with all of the sub-components of Burnout; a result that is also consistent with the results presented by Hetzel-Riggin et al. in 2020 when evaluating nurses and nursing students ( 47 ). By improving Work Engagement, organizations can significantly influence the experience of Emotional Exhaustion, Depersonalization, and Personal Accomplishment in their staff. However, directly modifying work attitudes, and more specifically Work Engagement, is challenging ( 14 ). The mediating role of Work Engagement between the work environment and Burnout that is identified in this study and explained below.

We identified Work Engagement as a significant mediator of the effect of Quality of Work-life on the subcomponents of Burnout. These results illuminate an important point: intervening on the work environment, without considering the mediating effects of Work Engagement, may have a limited effect on Burnout. Berta et al.'s study on Health Support Workers supports our model by where features of the work environment are related to Burnout through work attitudes, such as Work Engagement ( 14 ). Addressing Quality of Work-life occurs at the interface of the work environment and individuals' role identities. Some strategies to address Quality of Work-life include decentralized organizational structures, improved team work, key stakeholder involvement in decision-making, performance feedback and role clarity, incentive plans, and promotion opportunities from within ( 48 , 49 ). By improving work-life, there is also an opportunity to improve employees' overall life, through the concept of spillover ( 49 ). Sirgy et al. explain that spillover occurs when our reactions to work-life spill over into our non-work life, and note that the reverse can also occur ( 48 ). These could provide strategies for organizational leaders to influence pediatric nurse Burnout through Work Engagement with the modulation of the work environment.

Influencing Pediatric Critical Care Nurse Burnout

All three subcomponents of Burnout were influenced by Work Engagement. This means that hospital leadership can address Burnout through the influence of Quality of Work-life on Work Engagement.

Importantly, these results provide an evidence-based, directed strategy for administrators to target in a resource-limited system. The more engaged the nurse is with their work, the greater their sense of more Personal Accomplishment, and the less Emotional Exhaustion and feeling of Depersonalization (cynicism) they experience. This is supported by previous literature on the impact of Work Engagement on Burnout ( 14 , 50 ). Work Engagement can mediate the relationship between the demands of the job and nurse Burnout ( 47 , 51 , 52 ). Nurse Work Engagement also impacts the patients' experience of care ( 53 ). Increased nurse Work Engagement has been shown to have positive effects on both personal and organizational outcomes. To be able to increase nurses' engagement with their patients and families we must think about possible interventions in the same light. Highly engaged nurses are essential for ethical, safe, and comprehensive care ( 34 , 50 ). As Work Engagement is a work attitude that is difficult to directly influence, addressing areas of the work environment are instrumental in improving Work Engagement and, subsequently, Burnout. Quality of Work-life is not only directly correlated with Work Engagement, it is influenced by an employee's satisfaction with how their needs are being met through the resources, outcomes and activities that are derived from their participation in work, indicating that improving these factors of the work environment will also have a positive impact on nurse Burnout ( 26 ).

This study illustrates the importance of the impact of the work environment on Work Engagement and, subsequently, Burnout. We are hopeful that this data, and studies like it, will reinforce the thinking that workplace interventions can contribute in a meaningful way to reducing nurse Burnout. Many current workplace well-being recommendations focus only on self-care for pediatric nurse Burnout—our findings highlight that this recommendation is incomplete, and there are ways leadership can adapt the work environment to also optimize well-being ( 54 ). More needs to be done at an organizational level to intervene on the factors that significantly impact pediatric nurse Burnout in the workplace, as demonstrated in this study.

Limitations

This is a single center study in a Western setting, thus local context and experience limits generalizability ( 55 ). This is a cross-sectional study with a modest response rate which limits causal and temporal inference. Nurses historically have fairly poor survey response rates (<60%) ( 56 ). The results are sufficient to provide targeted recommendations for interventions at this study site ( 57 ), and, by providing a detailed description of the study context, the findings aim to be reproducible and adaptable to other health care settings and populations such as other pediatric critical care units and even pediatric nurses as a whole. The data reflects nurses who chose to participate in the study and may be influenced by selection bias. Effort was made to recruit a sample that is representative of the critical care nursing population at SickKids through distribution to all eligible participants, however despite our best efforts, the sample is not identical to the actual sample distribution. There is also vulnerability to possible bias in the responses due to perceived social desirability, despite anonymity. Participants self-selected to participate in the study; this could have introduced bias in that those with the most extreme feelings may be over-represented.

Path analysis is an explanatory technique and thus is guided by known or hypothesized relationships from the literature. It is important to note that the primary limitation of path analysis is that it does not infer causality or directionality ( 58 ).

We acknowledge the impact of the COVID-19 global pandemic and, specifically, its impact on front line essential workers such as pediatric critical care nurses. Nurses, now more than ever, are experiencing the impacts of their work on their well-being; these results will be timely and readily implementable. Further research to confirm and explore these results with pediatric critical care nurses is needed to fully illuminate the conclusions and to design practical interventions to address Burnout. Phase 2 of this study will aim to address this component.

Theoretical Contributions

At this time, and to our knowledge, there are no previous studies that have considered all of the concepts explored here simultaneously, nor could we find previous studies that have ranked the correlation of work attitudes and work environment factors' contributions to pediatric nurse Burnout. Therefore, the findings of this study advance the understanding of the impacts of the work environment and work attitudes on the work outcome of Burnout in pediatric critical care nurses.

We found that, in this single center study of pediatric critical care nurses, Burnout levels were high. Pediatric critical care nurse Burnout was most impacted by Work Engagement and quality of work life. Work Engagement is a significant mediator between the work environment and the subcomponents of Burnout. Future interventions for pediatric nurse Burnout by modifying work environment, particularly through the modulation of Work Engagement, have the potential to positively impact the well-being of nurses, and ultimately the care they provide to our most vulnerable patients.

Data Availability Statement

Ethics statement.

This study was approved by the Research Ethics Board at the Hospital for Sick Children in Toronto, Canada (REB #1000072502). It is also approved by the University of Toronto. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

LB was involved in the study design, data collection, data analysis, data interpretation, and drafting and finalizing the manuscript. WB and KC were involved in data interpretation, and substantively revised the manuscript for important intellectual content. KW was involved in the study design, data interpretation, and substantively revised the manuscript for important intellectual content. All authors read and approved the final manuscript and agree both to be personally accountable for their own contributions and to ensure that questions related to the accuracy or integrity of any part of the work are appropriately investigated, resolved, and the resolution documented in the literature.

This study is funded by the Alma Rae Nursing Scholarship and through the Lawrence S. Bloomberg Faculty of Nursing Doctoral Program and the Grace Evelyn Simpson Reeves Award through the Hospital for Sick Children (Toronto, Canada).

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's Note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Acknowledgments

We would like to thank Shelby Watson for her assistance with data collection, Sarah Brennenstuhl for her assistance with data analysis, and all of the critical care nurses at the Hospital For Sick Children for their dedication to providing excellence in pediatric critical care. Kristin Cleverley was supported by the CAMH Chair in Mental Health Nursing Research while writing this article.

Abbreviations

• Nursing Science
• Pediatric Nursing

Pediatric Nursing Care and Its Practices in Three Health Care Facilities

• January 2020
• Open Journal of Nursing 10(12):1275-1293
• 10(12):1275-1293
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Qualitative research: methodologies and use in pediatric nursing

• PMID: 2090649
• DOI: 10.3109/01460869009009035

With the increasing number of qualitative research studies being published in nursing journals, pediatric nurses need to understand the different qualitative research methodologies in order to adequately critique these studies and utilize the findings in their clinical practice. Three of the most prominent methodologies in qualitative research are discussed: phenomenology, ethnography, and grounded theory. Examples of published qualitative research in pediatric nursing are described to illustrate each of the three methodologies.

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SPN is the premier pediatric society representing over 3,600 pediatric nurses and 28 specializations. SPN strives to support nurses in their practice by providing educational resources, news in pediatric trends, and opportunities to network with nurses around the country. 

The mission of the Society of Pediatric Nurses is to advocate for the specialty of pediatric nursing by advancing excellence in education, research and evidence-based practice.

The Society of Pediatric Nurses will be the premier professional nursing organization that establishes and promotes nursing standards of excellence for the care of children and their families.

Accountability to pediatric nurses and to decision making that reflects diversity, equity, inclusion and contributes to the pediatric nursing profession; Dedication to life-long learning, generation of new knowledge and scholarship, innovation, and advocacy for the best quality of pediatric nursing for all children and families.

Transparent, respectful, ethical and fiscally responsible decision-making and actions.

Seeking diversity of thought, inspiring innovative and relational collaboration, while advancing the leadership and practice of all pediatric nurses.

Development, dissemination, and diffusion of knowledge and evidence-informed standards of care that support diversity, equity and inclusion to ensure the best care for all children and families.

The Society of Pediatric Nurses (SPN) remains dedicated to its mission of advancing the specialty of pediatric nursing through excellence in education, research, and practice. SPN values its diverse membership providing care across roles, settings, geographic locations and patient populations.

Our patient population and members are diverse, with different intersecting characteristics including skin color, body size, race, ethnicity, country of origin, language spoken, sexual orientation, ability, socioeconomic status, education level, religion, gender identity and more.

SPN will continue to harness the power of varied viewpoints and lived experiences, following through with action as well as word. SPN is dedicated to evaluating diversity, equity and inclusion at an organizational level and within its membership. Additionally, SPN will provide evidence-informed guidance and support for caring for the full spectrum of challenges facing pediatric populations today. SPN will provide resources for all pediatric nurses to educate themselves on how to care for diverse populations, to celebrate diversity within their workplaces, and to acknowledge the contributions of minority populations towards the advancement of pediatric nursing.

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Venous Thromboembolism Prophylaxis in High-Risk Pediatric Trauma Patients

• 1 Children’s Wisconsin, Medical College of Wisconsin, Milwaukee
• 2 Nationwide Children’s Hospital, Columbus, Ohio
• 3 Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio
• 4 C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor
• 5 Nemours Surgical Outcomes Center, Nemours Children’s Health – Delaware Valley, Wilmington
• 6 Comer Children’s Hospital, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
• 7 Johns Hopkins Children’s Center, The Johns Hopkins University, Baltimore, Maryland
• 8 Riley Children’s Health, Indiana University Health, Bloomington
• 9 American Family Children’s Hospital, University of Wisconsin Health, Madison
• 10 Norton Children’s Hospital, University of Louisville, Louisville, Kentucky
• Invited Commentary Pediatric Venous Thromboembolism—Understanding in Evolution Michael R. Phillips, MD, MSCR; Laura N. Purcell, MD, MPH; Anthony G. Charles, MD, MPH JAMA Surgery

Question   Does the application of high-risk guidelines allow for safe and appropriate administration of venous thromboembolism (VTE) prophylaxis following pediatric trauma?

Findings   In this cohort study applying high-risk criteria to guide VTE prophylaxis, more than half of patients received prophylaxis without any documented bleeding complications. Increased time to prophylaxis initiation was significantly associated with increased likelihood of developing VTE.

Meaning   Use of VTE prophylaxis in high-risk pediatric trauma patients is safe, and further studies may focus on timing of prophylaxis and barriers to implementation of guidelines.

Importance   The indications, safety, and efficacy of chemical venous thromboembolism prophylaxis (cVTE) in pediatric trauma patients remain unclear. A set of high-risk criteria to guide cVTE use was recently recommended; however, these criteria have not been evaluated prospectively.

Objective   To examine high-risk criteria and cVTE use in a prospective multi-institutional study of pediatric trauma patients.

Design, Setting, and Participants   This cohort study was completed between October 2019 and October 2022 in 8 free-standing pediatric hospitals designated as American College of Surgeons level I pediatric trauma centers. Participants were pediatric trauma patients younger than 18 years who met defined high-risk criteria on admission. It was hypothesized that cVTE would be safe and reduce the incidence of VTE.

Exposures   Receipt and timing of chemical VTE prophylaxis.

Main Outcomes and Measures   The primary outcome was overall VTE rate stratified by receipt and timing of cVTE. The secondary outcome was safety of cVTE as measured by bleeding or other complications from anticoagulation.

Results   Among 460 high-risk pediatric trauma patients, the median (IQR) age was 14.5 years (10.4-16.2 years); 313 patients (68%) were male and 147 female (32%). The median (IQR) Injury Severity Score (ISS) was 23 (16-30), and median (IQR) number of high-risk factors was 3 (2-4). A total of 251 (54.5%) patients received cVTE; 62 (13.5%) received cVTE within 24 hours of admission. Patients who received cVTE after 24 hours had more high-risk factors and higher ISS. The most common reason for delayed cVTE was central nervous system bleed (120 patients; 30.2%). There were 28 VTE events among 25 patients (5.4%). VTE occurred in 1 of 62 patients (1.6%) receiving cVTE within 24 hours, 13 of 189 patients (6.9%) receiving cVTE after 24 hours, and 11 of 209 (5.3%) who had no cVTE ( P  = .31). Increasing time between admission and cVTE initiation was significantly associated with VTE (odds ratio, 1.01; 95% CI, 1.00-1.01; P  = .01). No bleeding complications were observed while patients received cVTE.

Conclusions and Relevance   In this prospective study, use of cVTE based on a set of high-risk criteria was safe and did not lead to bleeding complications. Delay to initiation of cVTE was significantly associated with development of VTE. Quality improvement in pediatric VTE prevention may center on timing of prophylaxis and barriers to implementation.

• Invited Commentary Pediatric Venous Thromboembolism—Understanding in Evolution JAMA Surgery

Read More About

Witte AB , Van Arendonk K , Bergner C, et al. Venous Thromboembolism Prophylaxis in High-Risk Pediatric Trauma Patients. JAMA Surg. Published online July 31, 2024. doi:10.1001/jamasurg.2024.2487

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Open Rank, Non-Tenure Track Pediatric Nursing Faculty

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Position Overview: The School of Nursing and Health Sciences at Merrimack College in North Andover, Massachusetts is seeking an outstanding and highly motivated faculty member to join our bachelor of science in nursing program. We invite applicants to become an integral team member of our nursing department, which sits in the dynamic School of Nursing and Health Sciences, established in 2017. Applications for non-tenure track (Assistant/Associate Clinical Professor) 9-month contract faculty positions in nursing, to begin in Spring 2025 are now being requested. Merrimack College recently opened a state-of-the-art Nursing Center. This space includes 6 simulation labs, 2 classrooms; 2 debrief rooms, 15 faculty offices and 2 large student collaborative spaces. Merrimack College is committed to diversity, equity, and inclusion. We seek candidates with a demonstrated ability to work with students across a broad range of social and personal identities and perspectives and a commitment to prepare students to serve a diverse population. We particularly encourage applications from members of historically underrepresented groups. The ideal candidate should be highly experienced and skilled in undergraduate pediatric nursing curriculum and course development, NCLEX preparation and testing, and clinical and didactic instruction in the pediatric nursing field. Experience in simulation development, implementation and evaluation would be a plus. Candidates will be expected to teach undergraduate courses in the areas of pediatric nursing practice, and other courses based on areas of expertise; advise students; contribute to curriculum and policy evaluation and improvement, state and national accreditation maintenance, governance and evaluation of all nursing program components. Position Qualifications:

• Master’s degree in nursing is required for the non-tenure track, Doctoral preparation is preferred.
• Current/unencumbered Massachusetts state RN license, healthcare provider CPR and immunizations as recommended by the Massachusetts Department of Health.
• A minimum of two years of full-time experience in pediatric nursing, within the last five years and evidence of clinical competence in the area of clinical instruction required; additionally, nursing education teaching at the college level preferred.
• Outstanding record of professional service commensurate with career stage.
• Excellent clinical skills in pediatric nursing to support clinical education.
• Understanding of healthcare disparities and disparate needs of underserved communities.
• Evidence of a commitment to diversity in research, education, and in clinical practice.

Application Materials Should Include:

• Cover letter stating motivation and interest in the position, citing experience relevant to the qualifications and including experience with, and commitment to, our Catholic Augustinian mission, our values, and our desire to be a more diverse, equitable and inclusive institution of higher learning.
• Resume or Curriculum Vitae
• Teaching Statement
• Contact information for three professional references

This position is subject to the successful completion of a criminal background check. Vaccinations and Remote Work

This is an on-campus position as employees are essential in order to provide a fully on-campus, residential college experience for our students and the community.

The COVID-19 vaccine and booster for which an individual may be eligible are highly recommended for students, faculty and staff. Merrimack College does not require proof of COVID vaccination for enrollment, employment or to be a guest on our campus. Statement on Our Mission

Merrimack College is a Catholic Augustinian institution of higher education committed to building a culturally and racially diverse community. Our mission is to enlighten minds, engage hearts and empower lives and is inspired by our Catholic faith and the Augustinian tradition of seeking truth through inquiry and dialogue.

Merrimack College seeks candidates who understand, respect and can contribute to Merrimack’s Catholic and Augustinian mission and values and advance our work in the area of diversity, equity and inclusion. We strongly encourage applications from members of underrepresented groups. All candidates should describe in their application previous experience related to equity, diversity, and inclusion, as well as how they will engage in fostering a culture that supports our Catholic and Augustinian mission and our values of diversity, equity and inclusion. About Merrimack College

The only Catholic, Augustinian institution of higher education in New England, Merrimack College is a private, independent, coeducational institution with more than 4,000 undergraduate and 1,400 graduate students from 43 states and 42 countries. The College features more than 100 career-focused undergraduate, professional and graduate programs, all taught by exceptional faculty who are passionate about their subject and student success. The College has five schools: arts and sciences, engineering and computational sciences, nursing and health sciences, education and social policy and the Girard school of business. The College’s suburban 220-acre campus is just north of Boston in North Andover, Massachusetts. Merrimack is a Master’s Colleges and Universities/Larger Programs (M1) institution in the Carnegie Classification of Institutions of Higher Education. Merrimack is one of the fastest growing educational institutions in the country and has steadily climbed up in the U.S. News & World Report’s ranking of Best Colleges, ranking 33rd in the Regional Universities North category in 2024. Merrimack is a NCAA Division I athletic institution.

Merrimack College is an Equal Opportunity Employer.

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