Theresa A. Mikhailov, Bonnie Stojadinovic
Medical College of Wisconsin, USA
Theresa A. Mikhailov completed her M.D. from Northwestern University Medical School and her Ph.D. in Epidemiology from the University of Illinois Chicago. She is an Associate Professor of Pediatrics at the Medical of Wisconsin and the Medical Director of its Pediatric Critical Care Nurse Practitioner Program and its Pediatric Critical Care Nutrition Program as well as the Administrative Director of its Pediatric Palliative Care Nurse Practitioner Program. She has published more than 15 papers in reputed journals. She has served as a Co-chair and Physician Liaison for the APN Sub-committee of the Society of Critical Care Medicine’s Pediatric Section.
Effective care delivery in the pediatric tertiary care setting has become increasingly problematic over recent years due to changes in available providers. This is related to a shift in the focus of post-graduate medical education from tertiary to primary care and expanded duty hour restrictions for physicians in training which limits their availability to provide tertiary pediatric care. Furthermore, the sub-specialization of pediatric intensive care units has increased the need for critical care providers. The problem has been further compounded by inadequate numbers of trained acute care pediatric nurse practitioners (ACPNP) since until recently there were only a few programs available to train ACPNP providers in the United States. In an effort to address these issues, Marquette University College of Nursing partnered with the Medical College of Wisconsin and Children’s Hospital of Wisconsin in 2009 to bring local pediatric nurses interested in pursuing advanced practice training, the opportunity to do so locally. These collaborative efforts have assisted in preparing ACPNP students develop roles in multiple acute care pediatric specialty areas such as in gastroenterology and critical care and to function as highly qualified providers in these areas. The Pediatric Critical Care Division at the Medical College of Wisconsin developed a unique Attending Physician/ACPNP staffing model to deliver direct care to critically ill children that serves as an example for other programs regionally and nationally. Furthermore, these models of care delivery and ACPNP training, education, and preparation could be replicated by other organizations nationally and internationally, when faced with similar issues.