What's a PNP?

The Pediatric Nurse Practitioner (PNP) is an advance practice registered nurse who provides patient care to children and young adults.  To function in this role, the PNP must have completed a formal educational program specializing in pediatric primary* health care and have met the State Board's regulations that govern advanced practice nursing.

*"Primary Care is the provision of integrated, accessible health care services by clinicians who are accountable for a large majority of personal health care needs, developing a sustained partnership with patients and practicing in the context of family and community. " Institute of Medicine(1996)


In their 1992 Position Statement on Entry into Practice, the National Association of Pediatric Nurse Associates and Practitioners (NAPNAP) endorsed the master's level for the educational preparation of PNP's. The Educational focus of PNP programs is on the care of children (infants through young adults).  The curricular content includes growth and development, pathophysiology, pharmacology, physical, developmental, family and cultural assessment, laboratory skills, and diagnosis and management of common childhood illnesses, minor traumas, chronic conditions and behavioral problems.  The curriculum includes both didactic and clinical practice components. 

Practice Parameters:

PNP's practice under their state Nurse Practice Act, and in accordance with individual state laws and regulations.  Since all fifty (50) states vary in their regulations as to the definition, scope of practice and prescriptive authority of nurse practitioners, specific state requirements for practice must be identified and met.  Currently all fifty (50) states have delegated some degree of prescriptive authority.  Prescription of appropriate drugs is an essential and necessary component of comprehensive patient management by PNP's. 

PNP's are pediatric health care professionals who provide primary care to children (infants through young adults) through assessment, diagnosis, treatment and evaluation of care.  In accordance with state licensure, and regulatory mechanisms, PNP's provide a wide range of pediatric health care services including, but not limited to, the following:

  • Health histories

  • Physical Examinations

  • Diagnosis, treatment, and management of common pediatric illnesses, minor traumas, chronic conditions, and behavioral problems

  • Order diagnostic laboratory tests

  • Prescribe age-appropriate medications

  • Counseling and education of children and their families

PNP's provide pediatric health care services in a variety of health care and community settings. The PNP may consult with other members of the health care team, may coordinate care and/or make referrals to other members of the health care team.

Dependant upon state Nurse Practice Acts, licensure and regulatory mechanisms, health care services provided by PNPs include, but are not limited to, the following:

Assessment and Diagnosis:

  • Obtain a comprehensive health history

  • Perform physical examinations

  • Order and interpret age-appropriate screening and laboratory tests

  • Order and interpret common diagnostic procedures, I.E., X-rays, etc.

  • Asses and diagnose common childhood illnesses, minor traumas, chronic conditions, or any other condition that falls within the expertise and knowledge of the PNP

  • Formulate a family-centered health care plan recognizing the child and family as active participants

  • Consult with physicians and other health care providers when necessary

  • Coordinate patient care and make appropriate referrals


  • Treat common childhood illnesses, minor traumas, chronic conditions, or any other condition that falls within the expertise and knowledge of the PNP

  • Prescribe medications (within limits of prescriptive authority)

  • Provide appropriate child, or young adult, family education regarding purpose, regiments, side-effects, and possible interactions of medications and/or treatments

  • Provide for appropriate follow-up care

  • Teach, counsel and advise children (infants to young adults) and their families about current health status, illnesses, and health promoting activities

  • Utilize any other appropriate intervention(s) within the parameters, expertise and knowledge of the PNP

  • Consult with physicians and other health care providers when necessary

  • Coordinate patient care and make appropriate referrals

  • Identify community resources and coordinate referrals for problems beyond the scope of practice

  • Advocate for patients and their families


  • Monitor and evaluate effectiveness of prescribed treatment plans

  • Monitor child and family response to treatments

  • Modify interventions based of effectiveness, evidence-based practice and individual child and family needs

  • Monitor effectiveness of practice through client database and outcomes evaluation

Professional Accountability:

As health care professionals, PNPs:

  • Use a scientific and theoretical foundation for practiceFunction in a variety of roles such as health care provider, consultant, educator, researcher, and administrator

  • Promote the role of the PNP to the public and other health care professionals

  • Support education and role development of novice practitioners by serving a preceptors, role models, and mentors

  • Maintain active membership in professional organizations demonstrate practice consistent with professional standards, including current NAPNAP recommendations and State Board of Registered Nursing regulations for advanced nurse practitioners

  • Demonstrate practice consistent with legal standards and compliance with any applicable state and federal regulations

  • Maintain clinical competency through continuing education

  • Modify practice consistent with current practice guidelines and clinical recommendations for primary health care of children

  • Meet and maintain eligibility for national and/or state certifications

  • Assume accountability for professional actions, including incorporating risk management strategies into clinical practice

  • Maintain appropriate malpractice coverage

  • Advance the profession through enhancing public awareness and employer familiarity with the PNP role and scope of practice


PNP Certification provides evidence of professional knowledge and a clinical competency, promotes the delivery of quality health care, and is required by many states. NAPNAP encourages all PNP's to take as national qualifying examination that measures the knowledge necessary for a PNP to meet the standards of professional practice. In doing so, it serves to assure the public of the certified PNP's level of knowledge to practice safely. 

Upon completion of an accredited masters in nursing or post-masters PNP educational program, new PNPs are strongly advised to seek national certification. Currently there are two nationally recognized certification bodies that offer PNP certification: the National Certification Board of Pediatric Nurse Practitioners and Nurses (NCBPNP/N) and the American Nurses Credentialing Center (ANCC). Both offer initial certification and mechanisms for ongoing maintenance. The credential CPNP (Certified Pediatric Nurse Practitioner) is used by those certified by NCBPNP/N. This certification is valid for six (6) years. Requirements for certification maintenance include an annual self-assessment exercise, annual documentation of either 10 contact hours/academic credits or 200 clinical hours and five contact hours/academic credits; or by re-examination within seven years of initial certification. The credentials CS (Certified Specialist) recognize PNPs who are certified through ANCC. ANCC certification is valid for five (5) years with a recertification process requiring evidence of clinical practice as well as CEU credits, or retaking the written certification exam.