Our Nursing Programs
At Nemours, we know that how you do something is just as important as what you do. By establishing goals and continuously monitoring benchmarks — and then bringing that knowledge directly to the bedside — we are able to achieve ongoing success while raising the bar on patient care, safety, and service.
Nursing in Delaware Valley
Whether its on the floors of the Nemours/Alfred I. duPont Hospital for Children in Delaware, in an outpatient clinic in Pennsylvania or New Jersey, or as a community educator, our nurses have countless opportunities to make an impact in the lives of children.
This 22-bed unit is designated for short-term and acute rehabilitation of both traumatic brain injury and spinal cord injury, as well as comprehensive rehabilitation. In addition, ventilator-dependent patients, medically complex, orhthopedic complex and medical-surgical patients.
The unit participated in a Commission on Accreditaion of Rehabilitative Facilities (CARF) survey in 2004 in which it received full accreditation.
This 10-bed unit provides comprehensive care for patients undergoing blood and bone marrow (stem cell) transplantation, as well as inpatients receiving care from the Hematology Oncology subspecialty. All inpatient rooms are private, and the unit houses a family room, kitchen and playroom.
Admitting diagnoses include leukemias, brain/CNS tumors, solid tumors, neuroblastomas, solid organ malignancies, sickle cell disorders and other types of blood disorders. We also care for adult stem cell and bone marrow donors on this unit.
Nursing competencies required in this area include care of the stem cell transplant patient, including the administration of chemotherapy, biotherapy and post-chemotherapy/biotherapy monitoring and support. 3A/BBMT nurses must complete both a general nursing orientation as well as a comprehensive unit-based orientation program facilitated by a Hematology Oncology Nurse Clinician/Clinical Nurse Specialist.
Nurses who are newly employed in this patient care area are assigned to an experienced nurse preceptor who oversees and validates clinical competencies. Competencies are also accomplished and maintained through educational programs provided by the Nursing Professional Development team.
All nurses must maintain the Association of Pediatric Hematology Oncology Nurses Chemotherapy Biotherapy Provider status and demonstrate clinical competency in the administration of chemotherapy to pediatric patients. All registered nurses are certified in Pediatric Advanced Life Support (PALS), and have completed the course requirements for the Emergency Nurse Provider Course (ENPC).
The 21-bed Hematology/Oncology unit provides care to patients with various types of cancer and blood disorders. Each patient room is equipped with state-of-the–art Cardio-respiratory bedside monitors and computers that enable the healthcare team to access a patient’s electronic medical record. These computers are also used in the bar-coding administration of medications.
Bar-coding ensures patient safety by verifying that the correct medication is given to the appropriate child. This unit also provides care for patients requiring services from other medical and surgical subspecialties, including endocrinology, neurology/neurosurgery, otolaryngology and rheumatology.
Admitting diagnoses include leukemia, brain tumors, solid organ malignancies, sickle cell disorders and other types of blood disorders, diabetes, seizures, and shunt revisions. In addition, we partner in the care of stem cell transplant patients.
We are committed to delivering the most comprehensive care possible. This includes education and providing hands-on training to patients’ families, to ensure that caregivers are able to comfortably and confidently handle any home medical care with may be necessary. Through the use of the Getwell:)Network® and Kids Health.org, we utilize our bedside entertainment and educational TV to provide additional patient and family education.
Nursing competencies required to work in this area include the completion of the Pediatric Chemotherapy and Biotherapy curriculum in conjunction with the Scope and Standards of Practice in Pediatric Oncology through the Association of Pediatric Hematology/Oncology Nurses. In addition, we support our staff to become Nationally Certified in their specialty.
We use the Synergy Model for patient care to guide nursing care. This model provides a structure for matching the patient’s needs with the nurses strengths to create assignments that lead to the best patient outcomes.
Members of the 3CN team include:
- nursing leadership team, comprised of the nurse manager, assistant nurse manager, charge nurses and the chairs of our Nursing Shared Governance Committees. Our Shared Governance Model allows for direct care nurses to provide leadership, education and evaluation to ensure the unit provides safe, quality and evidence-based care. We also value the partnership of unit aides and clerks to provide supportive care.
- hematology/oncology and medical clinical nurse specialists, who specialize in the care of our patient’s and support the team in providing best practice and outcomes.
- other members of the healthcare team, such as respiratory therapists, child life specialists, social work and therapeutic services, who are required for the child’s care.
This entire team works along with our patients and their families, to make the best possible choices for each child with eh goal of achieving optimal patient outcomes.
Unit 3C South
The surgical care unit is a fast-paced and progressive 23-bed unit that partners with families to provide care for patients with complex orthopedic, urologic and renal disorders, as well as trauma, general surgical and solid-organ transplants.
To work on this unit, nurses must first complete a comprehensive orientation provided in collaboration with the Nursing Professional Development team. Following a general orientation, nurses receive an additional six to eight weeks of individualized, precepted, unit-specific training. Ongoing continuing education is an expectation of all nurses. Opportunities to attend both internal and external conferences are available. Participation in our active unit- based shared governance activities is an additional opportunity.
Nurses on this unit have the opportunity to acquire advanced medical-surgical skills, including the management of postoperative pain using newer technologies, peritoneal dialysis, managing the care of solid organ transplant recipients and family education.
3E is a 21-bed unit which provides care for patients requiring respiratory, general pediatric, or gastrointestinal management.
Each patient room is equipped with state-of-the-art cardiorespiratory bedside monitors and computers that enable the health care team to access a patient’s electronic medical record. These computers are also used in the barcoding administration of medications. Barcoding ensures patient safety by verifying that the correct medication is given to the appropriate child.
We are committed to delivering the most comprehensive care possible. This includes educating and providing hands-on training to patients’ families, to ensure that caregivers are able to comfortably and confidently handle any home medical care that may be necessary. At each patient bedside, there is an entertainment and educational TV system, the GetWell:)NetWork®, that helps nurses provide this education.
We use the Synergy model for patient care to guide nursing care. This model provides a structure for matching the patient's needs with the nurse's strengths to create assignments that lead to the best possible patient outcomes.
The health care team consists of:
- the nursing leadership team, which consists of the nurse manager, assistant nurse manager, charge nurses, and the chairs of our Nursing Shared Governance committees, quality, research & education and practice. These are registered nurses who provide leadership, education and monitoring to ensure the unit provides safe, quality and evidence-based care.
- the unit aide, who assists with vital signs, intake and output and activities of daily living such as feeding, hygiene, and therapy play.
- the unit clerk, who is responsible for the clerical duties of the unit.
- the medical clinical nurse specialist, who is an advanced practice nurse who specializes in the care of children with medical conditions.
- other members of the health care team such as respiratory therapists, child life specialists and physical therapists who are required for the child's care.
This entire team along with our patients and their families works together to make the best possible choices for each child with the goal of achieving optimal patient outcomes.
3F is a 20-bed unit that specializes in the care of children with gastrointestinal disorders (such as Crohn’s disease, ulcerative colitis, GERD and pancreatitis), as well as other medical problems. In addition, our unit also cares for a variety of surgical patients as well as NICU graduates.
Each patient room is equipped with state-of-the-art cardiorespiratory bedside monitors and bedside computers that allow staff to access a patient’s electronic medical record. These computers are also used in the barcoding administration of medications. Bar-coding ensures patient safety by verifying that the correct medication is given to the appropriate child. 3F served as the pilot unit for the barcoding process, which now has been initiated hospitalwide.
Our staff is committed to delivering the most comprehensive care possible. This includes educating and providing hands-on training to patients’ families, ensuring that caregivers are able to comfortably and confidently handle any home medical care that may be necessary.
Our delivery of care model is patient-focused and provided by a team that includes many vital members, including:
- the nursing leadership team, which consists of the nurse manager,an assistant nurse manager and charge nurses, who assist the staff nurse in promoting safe, quality, compassionate care.
- the bedside nurse, who is accountable for assessing, planning and providing care to assigned patients.
- the patient care assistant, who assists with activities of daily living such as feeding, hygiene and play therapy.
- the patient service assistant, who is responsible for the clerical duties of the unit.
- the clinical nurse specialist, who collaborates on educational opportunities for patients and families, as well as staff.
- the social worker, who helps facilitate transitioning and discharge planning for families.
This entire team communicates to make the best possible choices for each child.
There are currently 60 Advanced Practice Nurses (APNs) practicing in over 25 various subspecialty divisions at the Alfred I. duPont Hospital for Children. Each APN is responsible for a specialized area of nursing practice, and provides direct and indirect care to patients and their families in the inpatient, ambulatory and outpatient setting.
APNs practice collaboratively with physicians, nurses and other health care professionals to provide quality pediatric care. They are supported to obtain prescriptive authority and are credentialed as affiliate members of the medical staff. They also benefit from a collaborative practice model, with direct reports to both the subspecialty division and the Department of Nursing.
Bimonthly APN Council Meetings offer APNs the opportunity to meet as a group with the APN Manager for networking, information sharing and educational discussions. APNs also support the professional development of the nursing staff by sharing their clinical expertise through staff nursing education, consultation and committee participation. APNs are encouraged to further their professional development through outside educational programs, research and publication.
The Ambulatory Care Centers (ACCs) at all our Nemours Delaware Valley sites provide care to children who are seen in our specialty outpatient clinics. Nurses who work in the ACCs typically provide assessment, direct and indirect interventions, minor procedures and patient education. There are approximately 153,000 visits to these clinics annually.
The Nemours Cardiac Center delivers superior care to infants, children and young adults with heart disease both acquired and congenital. Our facilities include an operating room used exclusively for cardiac patients and a new state of the art catheterization and electrophysiology suite. The 10 bed cardiac intensive care unit utilizes the most advanced technology to provide exceptional care to our most critical population. Our 13 bed telemetry and 3 bed step down units provide first rate care in a family focused environment. Our outpatient clinic serves the needs of the cardiac patients in the community.
The multidisciplinary cardiac team is comprised of specially trained surgeons, physicians, nurses, social workers, respiratory therapists, dietician and child life specialists, as well as consultation with hospital-wide disciplines. The team mission is to provide paramount service to cardiac patients and their families.
The Day Medicine Unit provides specialty focused care to children. These children have been seen by physicians in our specialty clinics and referred by primary care community physicians to the unit for specific services, such as IV infusions and sedations for special procedures. The unit can hold 10 patients at one time. The nursing staff from our unit sees approximately 880 patients each month.
The unit is open Monday–Friday, 7 a.m. to 7:30 p.m. On-call is covered every day after hours, for 24 hours, and every weekend and holiday for the Medical Imaging Department sedations.
The unit serves as a home base for a physician-nurse sedation team dedicated to the care of children needing sedation. The sedation team works in conjunction with the Anesthesia Department to provide a spectrum of services.
The nurses from the Day Medicine Unit provide care with procedures needing sedation: Day Medicine short procedures; including, but not limited to, orthopedics procedures, LP’s, I & D’s, EEG’s, knee injections, audiology and dental procedures as well as medical imaging procedures; including CT, nuclear medicine, interventional radiology, fluoroscopy, ultrasound & MRI.
The nurses care for both inpatients and outpatients, as often the mentioned procedures apply to both groups. Assignments may be changed throughout the day to meet the needs of the department. The ability of staff to adapt to change is the key to the functioning of the unit. The nurses strive to work with both families and patients to get the best outcome for the child.
We involve parents in the care of their child, encouraging them at the bedside. The nurses also work with child-life therapists for their expertise on medical role-playing and education of procedures, so the child has the most positive hospital experience possible.
The Dialysis Unit provides both inpatient and outpatient hemodialysis for patients from newborns to 21 years of age. Patients receiving home-based peritoneal dialysis are also treated by our staff. The recently renovated unit, designed in cooperation with nursing staff, physicians and administration, resulted in an outstanding, technologically advanced six-bed unit.
Nurses working on this unit receive a comprehensive orientation. Following a seven-day general orientation, an individualized educational plan is created for each nurse to ensure they are able to provide the highest quality of care to our patients. Opportunities for continuing education, clinical advancement, and participation in regional and national conferences are supported and encouraged.
The Emergency Department is a Level I Trauma Center caring for patients under the age of 18 presenting with a variety of illness and injuries. Patients are admitted without regard to race, religion, place of national origin or ability to pay. The average monthly census is approximately 3,900 patients.
The department is comprised of 17 monitored emergency treatment rooms, a six-bed Fast Track area handling non-urgent patients during defined hours and a six bed monitored observation area. All basic and advanced emergency life support equipment and supplies are maintained within specific rooms and within the department.
Nurses in the Gastroenterology Department assist physicians in providing specialty care to a diverse population of pediatric patients, many of whom need procedures in order to achieve a diagnosis or to address a medical problem.
The Gastroenterology Lab (GI Lab) is located within the Surgical Services Department. The GI Lab is an area that provides a safe and private environment for several different types of GI procedures. On average, 80–85 percent of the procedures completed are done on an outpatient basis. The GI Team frequently works in conjunction with the Anesthesia Department to provide services to both inpatients and outpatients.
Although the majority of the procedures are performed within this surgical services area, some procedures may be performed in other areas such as medical imaging or at the patient's bedside. The location of the procedure is based on the type of procedure that is required, as well as the severity of the patient's illness.
The Gastroenterology Lab is staffed by registered nurses Monday–Friday, 8 a.m. to 5 p.m. Eighty percent of the GI procedure nurses are certified. Nursing staff is allocated based on the complexity of the procedure as well as the individual patient's needs.
The Gastroenterology nurses follow the premise of the Synergy Model of nursing care in that the individual patients' characteristics are matched with the nurses' competencies. Any emergency GI procedures performed by the GI Team after hours are done in the operating room. The nursing staff has also been cross-trained to work in the outpatient Gastroenterology Clinic area or to assist in the office when the procedure activity is low.
This 6-member staff of registered nurses provides round-the-clock, 7-day-a-week services that include IV starts for inpatients and outpatients, difficult lab draws for inpatients, CVC repair and declotting of occluded central venous access devices.
In addition, the team has a pediatric PICC program that works collaboratively with Interventional Radiology, Child Life, and Social Work, to provide family-centered care for children requiring ongoing infusion therapy.
The KidsHealth On-Call nurse triage line provides after-hours support for Nemours’ primary care practices throughout Delaware and Southeastern Pennsylvania.
Despite its name, this service is not a part of the KidsHealth.org website.
If a parent calls their Nemours primary care physician after office hours, on holidays or over the weekend, the call is automatically directed to an on-call triage nurse who is trained to provide medical advice, and in some cases ED referrals, for health concerns such as fevers, earaches, traumas, etc.
The staff of registered nurses and clerical support help keep this service running smoothly when families need them most.
The Neonatal Intensive Care Unit (NICU) is a Level IIIC referral center primarily for newborn infants requiring surgery or services from the large array of subspecialists that are located here. The NICU also provides services to ventilator-dependent infants requiring airway evaluations and has a comprehensive trach/vent teaching program for families. The NICU is a collaborative effort of the Nemours/Alfred I. duPont Hospital for Children and Thomas Jefferson University.
In January 2008, we relocated to a beautiful new unit consisting of 14 single-patient rooms that support our philosophy of family-centered care. Our intent is to provide a comfortable, private and homelike environment. Each room is equipped with state-of-the-art cardiorespiratory monitors and computers that enable the health care team to access a patient’s electronic medical record. These computers are also used in bar-coding administration of medications and breast milk. Bar-coding ensures patient safety by verifying that the correct medication or breast milk is given to the appropriate infant.
We are committed to delivering the most comprehensive care possible. This includes educating and providing hands-on training to patients’ families, to ensure that caregivers are able to comfortably and confidently handle any home medical care that may be necessary. At each patient bedside, there is the GetWell:)Network®, an entertainment and educational TV system which helps to support the staff in providing this education.
The NICU staff use the Synergy model for patient care to guide nursing care. This model provides a structure for matching the patient’s needs with the nurse’s strengths to create assignments that lead to the best possible patient outcomes.
Members of the NICU team include:
- neonatologists (physicians trained to care for infants)
- neonatal nurse practitioners
- the nursing leadership team, which consists of the nurse manager, assistant nurse manager, charge nurses, direct care nurses and the chairs of our Nursing Shared Governance committees, quality, research & education and practice. These are registered nurses who provide leadership, education and monitoring to ensure the unit provides safe, quality and evidence-based care.
- direct care nurses, 50 percent have earned their specialty certification in neonatal intensive care nursing.
- the unit aide, who supports the nursing staff by delivering supplies and linens to each room, as well as assists with equipment cleaning and transporting of patients.
- the unit clerk, who is responsible for the clerical duties of the unit.
- the neonatal clinical nurse specialist, an advanced practice nurse who specializes in the nursing care of critically-ill neonates.
- other members of the healthcare team such as respiratory therapists, social work, nutritionists, a NICU pharmacist, and speech, occupational and physical therapists that are required for the infant’s care.
This entire team along with our patients and their family’s works together to make the best possible choices for each infant with the goal of achieving optimal patient outcomes.
The Nursing Professional Development Department exists to support the professional growth of all of the members of the Department of Nursing. This work starts with oversight of an individualized, unit-based, competency focused orientation and continues through each nurse's career journey.
Each of the members of the Professional Development Department has a role in supporting professional advancement, nursing shared governance and the work toward nursing excellence, using the perspectives of discovery, integration, application and education from Boyer's Model of Scholarship as an organizing framework.
Additionally this team provides a consultative role in the coordination of affiliating schools, provision of continuing education programs, offering of American Heart Association programs and support for nursing and organizational committees, task forces and councils. Nursing Professional Development strives to function in a creative, innovative, effective and cost-effective manner to support the Department of Nursing.
Since its establishment in 1940, the Nemours/Alfred I. duPont Hospital for Children has had a three-fold mission of patient care, education and research. The history of the Nursing Education Department has been deeply rooted in this same progressive vision. As part of this vision, Nursing Education is proud to unveil its state-of-the-art education center with simulation lab.
In recent years, changing health care trends, technological advances, an emphasis on evidence-based practice, and a focus on nursing recruitment and retention have all been instrumental in redefining the nursing education experience at Nemours. As the drive to deliver a fresh approach to nursing education got underway, it became clear that if nurses were to receive the highest quality hands-on training, state-of-the-art equipment and dedicated educators were essential.
In May 2005, a proposal was given to the hospital administration to facilitate acquiring a dedicated space with all essential equipment and supplies. With continuous efforts by the Education Department and Nursing Administration, this vision has now become a reality.
The Nursing Education Center — with its simulation lab, computers, classroom space, teleconferencing capability and top-notch educators — is now the cornerstone for our nurses’ professional advancement. We’re confident that in the future it will remain an important stepping stone for nursing staff as they pursue higher education and certification, and continue along their journey to excellence.
The Hematology/Oncology Clinic provides comprehensive outpatient services to children and families with hematological and oncological diagnoses.
Some of the services we provide in the outpatient clinic and day therapy area include:
- diagnostic workups
- peripheral IV insertion
- central line access and care
- medication administration
- chemotherapy and biotherapy administration
- blood product administration
- emergency care
- lumbar punctures
- pheresis services by the American Red Cross
- autologous blood collections for pre-operative patients
- pre-, post-, and intrasedation monitoring
- initiation of the admission process to the hospital
Nurses in the Hematology/Oncology Clinic are a vital part of a collaborative team that delivers supportive, disease-specific care and patient/family education on an ongoing basis. The clinic is staffed by five registered nurses, each assigned to various patient care roles each day. One nurse is assigned each day to the Phone Triage position, answering calls from patients and families regarding health concerns, treatment, diagnostics tests, medications and side effects.
In collaboration with the Hematologist/Oncologist, the Phone Triage Nurse prioritizes patient care needs, makes recommendations and referrals for treatment, and coordinates multidisciplinary care and patient services. The phone triage nurse also provides education and anticipatory guidance to families. Hematology/oncology clinic nurses must complete both a general nursing orientation as well as a detailed clinic-based orientation program facilitated by a hematology/oncology nurse clinician/CNS.
Nurses who are newly employed in the Hematology/Oncology Clinic are assigned to an experienced nurse preceptor who oversees and validates clinical competencies. All Hematology/Oncology Clinic nurses must maintain the Association of Pediatric Hematology/Oncology Nurses Chemotherapy Biotherapy Provider status and demonstrate clinical competency in administration of chemotherapy to pediatric patients. All registered nurses are certified in Pediatric Advanced Life Support (PALS).
The Pediatric Intensive Care Unit is a 22-bed unit that provides critical care and surveillance for patients with conditions such as acute and reversible loss of consciousness, respiratory failure, compromised air exchange, trauma related injuries, cardiovascular dysfunction, hepatic failure, hemodynamic instability, renal dysfunction, or central nervous system injury or dysfunction.
PICU nurses routinely perform treatments or interventions that utilize advanced life support technology. These may include cardiopulmonary resuscitation, tracheal intubation, pharmacologic support of circulation, mechanical ventilation, sampling of arterial blood gases, thoracentesis, and hemodynamic, intracranial pressure and intravascular monitoring.
Each patient room has electrocardiographic, pulse oximetry, respiratory, hemodynamic and intracranial pressure monitoring capability, as well as central EKG and respiratory monitoring. Portable monitoring during patient transport is also provided.
Special equipment in the PICU includes radiant warmer beds, heating/cooling blanket systems, Mapleson manual ventilation systems, end tidal CO2 monitors, ventilators, ventriculostomy systems, infusion pumps, blood warmers, continuous renal replacement systems and peripheral nerve stimulators.
The Perioperative Department provides care before, during and after medical and surgical procedures requiring anesthesia. Surgical services include general surgery, orthopedics, otolaryngology, plastic surgery, neurosurgery, urology and dental surgery. Endoscopy and diagnostic procedures, such as bronchoscopy, are also performed.
Pre-Surgery Care includes the Pre-Surgical Care Unit and Pre-op Holding Area, both of which prepare children and families for surgery. In both units, the child’s physical, psychological and social needs are addressed.
Pre-Surgical Care Unit
Within seven days of the surgery date, children will be scheduled for an exam in the Pre-Surgical Care Center. This exam will include any necessary tests/studies required for their surgery as well as any assessments of pre-existing medical conditions. The Pre-Surgical Care Center is staffed with advanced practice nurses and registered nurses. The APNs will perform the physical exam and the RNs will complete the nursing assessments, and provide pre-operative teaching for the child and parent/caregiver.
Pre-op Holding (Day of Surgery)
The nursing staff begins care the business day prior to surgery by contacting the parents/caregivers to inform them of the time to report to the hospital, to receive an update on the health status of the child and to tell them where to report. On the day of surgery, further assessments are done by the surgical team, including the surgeon and anesthesiologist, preoperative medications are given as needed and any additional preparation for surgery is done. The nursing staff provides age-appropriate games, videos or books to the patient while waiting for their surgery.
During Surgery, care is provided by a skilled team of registered nurses, licensed practical nurses and surgical technologists, who work closely with surgeons and anesthesiologists. This entire health care team is focused on the child's needs; during the intraoperative period they are continuously assessing, planning, implementing and evaluating the effectiveness of both the care provided and the child's response to the surgical procedure to ensure the best possible outcome. The OR Nursing team has implemented the Synergy Model for Patient Care, this care delivery model provides a framework for matching the nurse's competencies and strengths with the child's intraoperative care requirements.
Our intraoperative nursing leadership team consists of:
- the nurse manager and assistant nurse manager
- service coordinators
- nurse clinician level 3s
- the chairs of the Shared Governance Committees for (Quality, Practice, Research & Education and Management)
- clinical nurse specialist
These are Registered Nurses who provide leadership, education and monitoring to ensure the OR provides safe, quality and evidence-based care.
Post-Anesthesia Care Unit (PACU)
The Post-Anesthesia Care Unit is comprised of 2 units with a 32-stretcher/bed capacity. Nurses with education in post-anesthesia assessment provide care to patients in the immediate postoperative period. The nursing staff continuously monitors and assesses patients during their stay. They also assess the learning needs of the parent/caregiver.
Parents/caregivers are reunited with their child as soon as possible after surgery, giving the nurse the opportunity to provide education on the care of the child. Whether the child is going home following recovery, being admitted to the hospital or returning to a nursing unit, PACU nurses tell parents/caregivers what to expect, and continue to work closely with surgeons and anesthesiologists to guide the child safely through the postoperative period.
Nemours duPont Pediatrics provides primary pediatric care to the children of Delaware and Southeastern Pennsylvania. The Nemours Pediatrics network is comprised of 12 locations: 10 throughout Delaware and two in the Philadelphia area. Services include well-child care, routine physicals and immunizations, and sick office visits.
Nemours duPont Pediatrics accepts patients from birth to age 18. When necessary, referrals to pediatric specialists and subspecialists are made locally or to the Nemours/Alfred I. duPont Hospital for Children, depending on patient need.
The Critical Care Transport Team is responsible for the transport of sick and injured children, typically by ambulance but occasionally by helicopter. The most frequent destination is Nemours/Alfred I. duPont Hospital for Children, but requests for transport of hospital patients to other facilities for specialty services (i.e., severe burns) are honored as well.
The team is trained and equipped to care for patients with minor illnesses, as well as those with respiratory or neurological disorders that may require more aggressive management. The 2-person team — which consists of a pediatric intensivist and a registered nurse — operates 24 hours a day, 7 days a week.
They use specially designed equipment to maintain critical care during transport, including multiparameter vital-sign monitors, compact infusion pumps and defibrillators/external pacemakers. Advanced procedures performed by staff include vascular access (intravenous and intraosseous), endotracheal intubation, chest decompression and advanced airway management.
In addition to performing transports, staff also assist with patient care in the PICU, NICU, ER and other nursing units in the hospital.
The Utilization/Care Management team is comprised of seven care managers, an RN denial coordinator, a patient class conversion specialist as well as an administrative secretary. The care managers collaborate with medical, nursing and social work staff monitoring patient plans of care for timely completion and efficient use of resources, taking into account diagnostic and treatment services, tests, consultations and procedures. The care managers also oversee appropriateness of care using pre-established, health industry standards; facilitate patient flow during the inpatient stay; and proactively identify and address potential denials of payment.
The utilization and denial management team have been extremely successful in keeping the adjusted inpatient hospital denials at a minimum. These nurses work diligently with the nursing and medical staff, as well as the payers, to develop appeals to clinical denials and to assure full inpatient day approval and appropriate reimbursement. The patient class conversion specialist manages the multiple patient class and accommodation code changes.
Nursing in Jacksonville, Fla.
Nurses at Nemours Children Clinic, Jacksonville provide family-centered care to children that is evidence-based and tailored to the individual needs of each child and family. Our nursing team relies on a shared governance model of organization, which facilitates nursing participation and involvement in clinical decisions that affect patient care.
The Department of Anesthesiology and Critical Care Medicine at Nemours Children's Specialty Care, Jacksonville is anchored by board-certified anesthesiologists who have subspecialty training in pediatric anesthesia. The Department is complemented by a pediatric registered nurse who assists in coordinating presurgical consult clinic evaluations and pain service consults. All members are dedicated to the total care and treatment of the children and families we serve.
The Blood and Marrow Transplantation Program is a unique, collaborative effort of the Mayo Clinic, the Nemours Children’s Clinic and Wolfson Children’s Hospital. This allows for greater integration of physician and staff expertise, and a reliance on research and clinical protocols to ensure the best possible care for all patients.
Mayo Clinic maintains the program's adult transplant unit and cryopreservation laboratory, Nemours Children’s Clinic provides pre-transplant and post transplant care for children, and Wolfson Children's Hospital maintains the pediatric inpatient transplant unit.
The transplant program has been awarded national accreditation by the Foundation for Accreditation of Cellular Therapy (FACT) and is recognized by the National Marrow Donor Program (NMDP) as an affiliated center for matched unrelated donor transplants.
The Division of Endocrinology at the Nemours Children's Specialty Care, Jacksonville provides diagnostic and treatment services to infants, children and teenagers with a variety of disorders related to hormones. The Division has six board-certified pediatric endocrinologists, as well as board-certified nurse practitioners, pediatric registered nurses, nutritionists and certified diabetes educators.
There is an on-site blood drawing station as well as convenient scheduling for X rays and diagnostic imaging. Our diabetes program, staffed by Certified Diabetes Educators, is American Diabetes Association–recognized for its education. We are able to schedule and evaluate patients independently for diabetic teaching as well as insulin pump starts.
The Division is also extensively involved in clinical research activities. Board-certified registered nurse practitioners and registered nurses assist in the conduct of these studies. We also participate in multicenter trials of new therapies and devices used to treat pediatric hormonal problems. This allows patients to participate in innovative, original treatment options potentially not available elsewhere.
The Division of Gastroenterology, Hepatology and Nutrition at Nemours Children's Specialty Care, Jacksonville provides evaluation and treatment services for infants, children and adolescents with diseases of the digestive tract, liver and pancreas.
The division is composed of:
- three board-certified pediatric gastroenterologists
- three board-certified pediatric registered nurse practitioners
- several pediatric registered nurses (who assist clinically, case manage and coordinate research protocols)
- two registered dietitians
The Division has significant expertise in the management of patients with inflammatory bowel disease and participates in several multicenter and national research protocols, coordinated by both pediatric registered nurses and a board-certified nurse practitioner.
The Hematology/Oncology Division at the Nemours Children's Specialty Care, Jacksonville offers services in a broad range of blood and cancer diagnoses and treatments. It is one of a select group of nationwide institutions with a bone marrow transplant program.
Members of the division are actively involved in the development of the new treatment protocols. The Oncology Division has partnered with St. Jude’s Children’s Hospital and the University of Florida Proton Therapy Institute to provide care to children both nationally and internationally.
Nurses in this division act as primary case managers and provide clinical support. They also serve as patient advocates as well as provide educational and emotional support to families.
The nursing staff is comprised of:
- 5 oncology nurses
- 3 hematology nurses
- 2 bone marrow transplant program nurses
- 2 research nurses
- 2 nurse practitioners who manage the Long Term Follow-Up and Proton Therapy programs
Together, the nurses in the hematology/oncology division are committed to defining the best practices for optimal patient outcomes, and are passionate about providing the highest standards in patient care. Nurses within the federally funded hemophilia treatment center located at Nemours Children's Specialty Care, Jacksonville provide comprehensive hemophilia care and education locally, as well as to the Orlando and Pensacola areas.
They also assist with the Sickle Cell Program, once housed in two locations in Jacksonville but now consolidated in one location at the Nemours Children's Specialty Care, Jacksonville.
The Division of Hospital Pediatrics of the Nemours Children's Specialty Care, Jacksonville consists of skilled pediatricians and registered nurses who specialize in hospital-based care at Wolfson Children’s Hospital.
The pediatric registered nurses in this division serve first and foremost as a liaison between hospitalists and primary care providers for hospitalized patients. This includes meeting each patient and his or her family, attending daily rounds with the medical team, and serving as a nursing resource for the patient, family, hospital staff and medical team. A critical part of this role is continually informing and updating the primary care providers as to the condition and status of their patient.
The goal is that no child will be discharged from the hospital without the ability to receive proper follow-up by a physician or medical care provider. Our nurses are also responsible for gathering any medical data, such as newborn screens, growth charts and labs, that is pertinent to the patient’s care. They play an important role in collaborating with the medical staff, staff nurses, social workers, pharmacists and others in developing a plan of care for the patient.
The Division of Neurology offers comprehensive services for children with neurological, developmental, learning and language disorders. Board-certified pediatric neurologists, psychologists, Advanced Registered Nurse Practitioners, and professional nurses provide a wide array of specialized services, including a comprehensive epilepsy program. The headache clinic provides comprehensive educational sessions with the nurse and a psychologist as well as neurological assessment and treatment.
Children from North Florida and South Georgia with eligible neuromuscular disorders are treated through the Muscular Dystrophy Association clinic at Nemours. The Neurocognitive Assessment program provides consultation and psychoeducational assessment for developmental and learning problems. The electrophysiology laboratory provides diagnostic electroencephalography, electromyography and nerve conduction velocity testing, and inpatient monitoring in support of the epilepsy surgery program.
The division is active in clinical research and training programs. Training opportunities are also available for resident physicians from the Mayo Clinic Neurology Program, the University of Florida General Pediatric Program, local undergraduate and graduate nursing programs, and graduate psychology programs.
The Division of Psychology and Psychiatry at the Nemours Children’s Clinic in Jacksonville consists of pediatric psychologists; child and adolescent psychiatrists; and a dually board-certified psychiatric nurse practitioner/family nurse practitioner who are all engaged in clinical, research, and educational activities related to emotional and behavioral issues. The division offers psychological and psychiatric evaluations, a wide range of individual and group therapy services, and medication management to children up to age 18 and their families.
A major emphasis of the division is enhancing the emotional adjustment of children, adolescents and families to serious or chronic medical conditions, addressing stress-related physical symptoms, and issues related to treatment adherence.
The division houses the Center for Pediatric Psychology Research, a program that not only conducts research but also provides supervised clinical training to postdoctoral fellows, medical residents and master’s level and doctoral level advanced practice nursing students specializing in pediatric psychiatry.
Members of the division staff are frequent speakers to a variety of audiences about topics related to child behavior and development, parenting and specific psychological disorders.
The Division of Pulmonology/Allergy and Immunology at the Nemours Children’s Clinic in Jacksonville sees patients referred for diagnosis and management of childhood respiratory, allergic and immunologic diseases. The Division is the nationally accredited Cystic Fibrosis Care Center for the Northeast Florida and Southeast Georgia regions.
The Division also houses the Nemours Children’s Clinic Asthma Center, the only asthma program for children that integrates patient and family teaching with patient programs developed by pediatric specialists in both pulmonology and allergy/immunology. A board-certified pediatric nurse practitioner, registered nurses and respiratory-care practitioners provide assessment and teaching.
Florida Clinical Research Registered Nurses, nine in number from the Jacksonville Research Program, are working together to ensure the highest level of customer service to patients and are continually seeking process improvements to better serve customers. Best practices in customer relationship management are used to ensure excellent service in research.
Research study participants are given the ability to have flexible schedules and access to the research team to help facilitate recruitment. This helps to ensure that our goals are achieved for grants and clinical trials while adhering to budgets.
Nursing research continues to increase at Nemours under the guidance of Laurie Duckworth, PhD, winner of the 2008 Doughty Award for Advanced Registered Nurse Practitioner. Dr. Duckworth is a member of the Nemours-wide Clinical Research Review Committee and works with the Department of Otolaryngology/ENT to develop their research program under the leadership of Drs. Josephson and Rine.
Additionally, Dr. Doreen Radjenovic, ARNP and clinical nursing instructor at the University of North Florida, is also currently conducting research related to diabetes education along with the Division of Endocrinology in Jacksonville. Their efforts will further expand nursing research, which in turn will help the Nursing department to achieve Magnet Status.
The Spinal Defects Clinic provides comprehensive, coordinated, long-term management for patients with various forms of spina bifida and other conditions of the spinal cord. The team consists of providers from the Nemours Children’s Clinic, the University of Florida and Wolfson Children’s Hospital.
Pediatric specialists in neurosurgery, urology, orthopedics, gastroenterology, nursing, social work, physical therapy and occupational therapy evaluate each patient and participate in a post-clinic conference where recommendations for care are developed. Summaries of the visit and recommendations are compiled into a report that is sent to families and primary care providers.
The Division of Pediatric Surgery at the Nemours Children's Specialty Care, Jacksonville provides diagnosis and treatment of the surgical conditions of infancy, childhood and adolescence. The Division is staffed by board-certified surgeons who have demonstrated special competence in pediatric surgery.
Nursing services include case management, pre- and post-operative teaching (both in the outpatient and inpatient setting at Wolfson Children’s Hospital), wound care and management, and assistance with minor outpatient procedures. A pediatric registered nurse-driven clinic treating gastrostomy, cecostomy and appendicostomy tube issues is available.
The Division of Urology at the Nemours Children's Specialty Care, Jacksonville provides particular expertise for urinary and genital reconstructive surgery, management of neurogenic bladder dysfunction, and operative treatment of genitourinary tumors and congenital anomalies. A complete urodynamic laboratory is available for evaluation of children with enuresis.
A team of board-certified, fellowship-trained pediatric urologists, assisted by pediatric registered nurses, evaluate and treat conditions including urinary tract obstructions, ureteral reflux, urinary infection, hematuria, kidney stones and more.
Led by nurse practitioner Kim Jarczyk, MSN, ARNP, this program will provide comprehensive, coordinated services for children with urinary and fecal incontinence, urinary frequency and urgency, recurring urinary tract infection, failure to toilet train and chronic constipation.
The impact of urinary and fecal incontinence on children can be devastating. Because the dynamics of the bowel, bladder and pelvic floor are closely interrelated, organic or functional disruption in one of these systems can create a dysfunctional pattern of elimination affecting all of them.
Dysfunctional elimination is further complicated by developmental, psychosocial and behavioral problems. This program will address these medical and psychological issues simultaneously to achieve better outcomes.
Nursing in Pensacola, Fla.
The professional nursing practice at Nemours Children’s Clinic in Pensacola strives for excellence in patient and family care, guided by a “whatever it takes” service philosophy. Our nurses understand that the care experience must be one that respects a patient’s background and beliefs, and involve family members in every level of decision making.
The units where you will find our nurses include:
- otolaryngology or ENT
We also have nurses who are nationally certified as pediatric oncology nurses and several who are certified diabetes educators.
Nursing in Orlando
With our patient-families at the center of everything we do, and quality and safety as top priorities, pediatric nurses at Nemours Children’s Hospital in Orlando and Nemours Children's Specialty Care, Orlando strive for excellence every day.
The units where you will find our nurses include:
Nemours Children's Hospital
- 4 South
- 5 South
- Neonatal Intensive Care (NICU)
- Pediatric Intensive Care (PICU)
- Advance Practice Nurses
- Infusion Center
- Emergency Department (ED)
- Nursing Education
- Clinical Tactical Operations (Clinical TOC)
- Utilization Management
- Perioperative Department
- Pediatric Transport Team
- Special Procedure RN’s in Radiology
- PICC Team
- Sedation Nurses
Nemours Children's Specialty Care, Orlando
- Behavior and Development
- Blood Disorders (Hematology): Hemophilia, Sickle Cell Disease
- Cancer Care (Oncology)
- Cystic Fibrosis
- Ear, Nose and Throat (ENT, Otolaryngology): Audiology
- Genetic Disorders
- Hormones and Growth (Endocrinology)
- Infectious Diseases: HUG ME Center for HIV/AIDS
- Kidney and Urinary Health (Nephrology and Urology)
- Lung and Respiratory Care (Pulmonology): Synagis
- Nutrition and Weight Management: Healthy Choices Clinic, Metabolism
- Orthopedic Services: Muscular Dystrophy, Spina Bifida Program
- Sleep Medicine
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