Rebecca Flynn Notes How NPs, APPs Can Improve Triage Systems in Pediatric Dermatology Clinics

Rebecca Flynn, APRN, CPNP, a nurse practitioner (NP) at Children's Mercy Kansas City Dermatology, explains the myriad ways NPs and advanced practice providers (APPs) can help improve triage systems in dermatology clinics treating pediatric patients. She also highlights how the digital online atopic dermatitis clinical tool and the PedsGuide smart phone application module for atopic dermatitis that she helped create can expand care for pediatric patients with skin conditions.

Flynn presented at the Society for Pediatric Dermatology Annual Meeting in Toronto, Canada, which was held July 11-14.

This transcript has been lightly edited for clarity.

Transcript

What role does patient education play in the success of a triage program, and how can NPs and RNs collaborate to effectively educate patients about their conditions and treatment options?

Education is pivotal for the molluscum triage program. We developed the program so that nurses are able to provide education from transcripts that were developed by the nurse practitioner. Nurses are then able to educate families on the diagnosis and provide the pros and cons of each procedure if they choose to move forward with them, because we believe that families that are better educated and informed about their diagnoses are better able to make decisions for their patient care.

And as far as implementing the triage program, open communication is key. So we work very, very closely with our nurses, as the nurse practitioner, or APPs, is diagnosing through photos. We communicate with nurses so they're able to go in and give that proper education for the families. Through that, we have a very trusting relationship working in clinic, but it has been increased even more so working with our triage program together.

What are the key educational components that NPs and RNs should focus on to ensure patients are properly triaged for warts and molluscum, while maintaining revenue from procedural treatments?

Correct diagnosis is key. First, we have to establish that we have the proper diagnosis; then we can move on to the triage part where the nurses then provide the education. Once the nurse has the diagnosis, they're able to communicate that education, again review the risks and benefits of the procedures and move forward as the family chooses to schedule appointments if necessary. We realized through this triage process that not all patients needed to be seen in our clinic, but we wanted to make sure that we were able to see patients that wanted to be seen and still maintain the proper level of care to continue treatment for each of the diagnoses.

Could you discuss the impact of digital tools and applications, such as your atopic dermatitis clinical tool and smartphone module, on patient care and education in pediatric dermatology?

Education is everything. We spend much of our time as advanced practice providers giving our families education, but we realize part of our job is also to provide our primary care partners with education. So I set out to develop an online tool to help provide our primary care providers with the information and education we use in our clinics. We developed an online algorithm that gives all of the patient education handouts to our primary care partners that he or she can access when they're in primary care clinic. Our families can then receive their educational handouts with their primary care provider rather than coming to specialty care. Those tools are very useful, but they're a little cumbersome to access.

It was challenging to find them; you have to print them off and provide them. So we found if we could make it more accessible for our primary care partners, such as developing an app, they might be more apt to use it. Especially when they're in a busy clinic and they need that information right at their fingertips, they're able to utilize the online app and access the information; in fact, potentially triage a patient through a symptom checker to give a recommended infection that could be occurring as if they had a pediatric dermatology provider right there at their fingertips beside them in the clinic.

What advice would you give to aspiring pediatric nurse practitioners interested in specializing in dermatology, particularly in terms of professional development and pursuing educational opportunities?

For any advanced practice provider that would like to move toward dermatology, I highly recommend in your program of study, try to get your specialty rotation in dermatology. Not everyone can do that. My specialty rotation was actually in endocrinology, but it gave me a wealth of knowledge in endocrinology that I've been able to apply in my role as a pediatric dermatology nurse practitioner. So even from the years ago that I studied, I have used that information in my current role. But if the advanced practice provider that aspires to be in dermatology is not able to get that specialty clinical, do a shadow day. Anytime you can spend time with a dermatology nurse practitioner, you're going to gain more wealth and knowledge over time. Another key aspect is make sure that you find those key network companies that you can surround yourself with, the providers that are working in pediatric dermatology.

In our profession, there are 2 great opportunities. One is that at the Society for Pediatric Dermatology, we have an advanced practice provider special interest group that you could join, and also in the National Association of Pediatric Nurse Practitioners, we have a dermatology special interest group. And I would tell any new advanced practice provider, keep an open mind. You never know where your career is going to lead.

Personally, I spent my first 5 years teaching nursing school, and I utilized education in the classroom, in the clinical setting, and I never imagined my 5 years as an assistant professor of nursing carried over to my role as an advanced practice provider in pediatric dermatology, as I've spent much of my time disseminating the education to my partners and primary care providers, and future aspiring advanced practice providers as well.