Pediatric Nurse Practitioners' Developmental Screening Practices For Children Ages Birth To Three

Developmental screening is the process of using a validated screening tool to identify children at risk of delay. Studies have examined the developmental screening practices of pediatric primary care providers. However, no studies to date have explored the pediatric nurse practitioner (PNP) perspective. The specific purpose of this study was to gain information about the developmental screening practices of PNPs. Furthermore, the study explored how perceptions of their knowledge, skills, and attitudes regarding developmental screening may contribute to their screening behaviors. A qualitative grounded theory study was conducted using a purposive sampling of primary care pediatric nurse practitioners who care for young children. Six in-depth interviews were completed using a virtual platform. Strauss and Corbin's (1990, 2008) inductive approach to data analysis was used to code and interpret the data. A substantive theory of advancing screening competencies for young children's optimal development emerged from the data supported by six themes related to program and practice knowledge, skills, and attitudes. The themes included (1) developing awareness, (2) integrating connections, (3) taking an active role, (4) creating opportunities, (5) balancing learning expectations, vi and (6) understanding role and responsibilities. The PNPs in this study perceived that as they gain developmental screening experience, they continuously develop interrelated knowledge, skills, and attitude attributes, which contribute to advancing competencies and ultimately lead to more effective screening behaviors that support young children's optimal development. The PNPs in this study followed the American Academy of Pediatrics' developmental screening and surveillance guidelines for general and autism screening using standardized screening tools. They identified areas of program improvement related to developmental screening as additional preparation to work with diverse populations and increased opportunities to utilize the entire screening process. The study's PNPs identified current developmental screening facilitators as physicians, parents, and self-directed. They identified screening challenges as time, practice processes, and parents. The nurse practitioner workforce who care for young children is underrepresented in the literature. Additional research is needed to compare screening practices between pediatricians, family medicine physicians, and family and pediatric nurse practitioners to understand their screening practices and continue to improve developmental screening rates for young children.