PNP-AC vs PNP-PC

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Pediatric nurse practitioners (PNPs) specialize in providing a range of healthcare services to children from birth to early adulthood. Among nurse practitioners, there are two main subfields of practice: acute care and primary care. An acute care pediatric nurse practitioner (PNP-AC) focuses on patients with complex, acute, critical, and chronic illness, disability, or injury, while a primary care pediatric nurse practitioner (PNP-PC) emphasizes health promotion, disease prevention, and the management of minor episodic and chronic health problems.

The scope of practice for both acute care and primary care is based on patient need, and not necessarily setting-specific; however, primary care often takes place in a private practice or school-based clinical settings, while acute care usually takes place in emergency rooms, urgent care departments, and trauma centers.

There are many areas of overlap between primary care and acute care nurse practitioners, but also critical differences in schooling, certification, job duties, and continuing education.

PNP Acute Care PNP Primary Care
Education All pediatric nurse practitioners hold at least a master’s of science degree in nursing (MSN) from a program accredited by a professional organization such as the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Many PNP-ACs also go on to attain post-master’s or doctoral (DNP) degrees, as well as continuing education in their specialty area. All pediatric nurse practitioners hold at least a master’s of science degree in nursing (MSN) from a program accredited a professional organization such as the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE). Many PNP-PCs also go on to attain post-master’s or doctoral (DNP) degrees, as well as continuing education in their specialty area.
Typical Duties
  • Caring for children with complex, chronic, and critical illnesses
  • Conducting advanced physical assessments
  • Interpreting lab and diagnostic test results
  • Managing patients from admission to discharge
  • Coordinating aftercare options with patients and families
  • Diagnosing common illnesses
  • Performing routine checkups
  • Prescribing medication and other treatments
  • Ordering laboratory tests and performing immunizations
  • Counseling children and their families
  • Managing patients from youth to young adulthood
How many NPs join this profession? There are over 248,000 nurse practitioners licensed in the United States, of which only 0.6 percent specialize in pediatric acute care. There are over 248,000 nurse practitioners licensed in the United States, of which 4.6 percent focus in pediatric primary care.
Licensing and Certification

Pediatric nurse practitioners have options when it comes to federal-level certification.

The Pediatric Nursing Certification Board (PNCB) can provide the Certified Pediatric Nurse Practitioner Acute Care (CPNP-AC) credential for acute care PNPs. Applicants must be RN license holders with 500 hours of supervised direct care clinical practice in acute care pediatrics. They also need to have completed three separate and comprehensive graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology.

The American Association of Critical-Care Nurses (AACN) provides the CCRN (Pediatric) certification for acute care PNPs. Applicants must have 1,750 hours in direct care of acutely/critically ill pediatric patients in the past two years, or 2,000 hours of such care in the last five years.

As a supplemental license, the American Heart Association (AHA) provides Pediatric Advanced Life Support (PALS) certification, which focuses on skills such as basic life support and resuscitation, with the goal of improving care for seriously ill children.

Please note that in addition to federal-level certification pediatric nurse practitioners in acute care need to be licensed through their state of practice.

Pediatric nurse practitioners have options when it comes to federal-level certification.

The Pediatric Nursing Certification Board (PNCB) can provide the Certified Pediatric Nurse Practitioner Primary Care (CPNP-PC) credential for primary care PNPs. Applicants must be RN license holders with 500 hours of supervised direct care clinical practice in acute care pediatrics. They also need to have completed three separate and comprehensive graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology.

The American Nurses Credentialing Center (ANCC) offers the Pediatric Primary Care Nurse Practitioner Board Certification (PPCNP-BC) for primary care PNPs. Applicants must have practiced for the equivalent of two years full time as a nurse, completed 2,000 hours of specialty practice in the last three years, and completed 30 contact hours in the certification specialty.

Please note that in addition to federal-level certification, pediatric nurse practitioners in primary care need to be licensed through their state of practice.

Continuing Education Requirements

Certifications must be renewed regularly to demonstrate competency, but the timeframe and conditions of renewal vary between issuing organizations.

The PNCB certification must be renewed every year, and renewal applicants must have completed at least 15 contact hours. Every seven years, applicants must complete an additional 15 contact hours in pediatric pharmacology. Specific requirements may be found in the recertification guide.

The AACN certificate must be renewed every three years. Renewal applicants must have completed 432 hours of direct care of acutely/critically ill pediatric patients during the three-year certification renewal period, and must also either complete 100 Continuing Education Recognition Points (CERPs) in specified categories or renew by exam. Specific requirements can be found in the renewal guide.

The PALS certification does not need to be renewed, but initially earning the certification can, in itself, count as continuing education hours.

Certifications must be renewed regularly to demonstrate competency, but the timeframe and conditions of renewal vary between issuing organizations.

The PNCB certification must be renewed every year, and renewal applicants must have completed at least 15 contact hours in that time. Every seven years, applicants must complete an additional 15 contact hours in pediatric pharmacology. Specific requirements may be found in the recertification guide.

The ANCC certification must be renewed every five years, and applicants must have completed at least 75 contact hours. Specific requirements may be found in the renewal guide.

Common Practice Settings
  • Intensive Care Unit
  • Sub-Specialty Clinic
  • Emergency Room
  • Inpatient Hospital
  • Home Care
  • Private Practice
  • School-Based Clinic
  • Community Clinic
  • Outpatient Hospital
  • Home Care
On-Campus Programs
Online Programs
Helpful Professional Organizations

The Pediatric Nursing Certification Board (PNCB) Acute Care PNP Corner provides a wealth of information and collected links on continuing education, benefits, awards, and more for acute care nurse practitioners.

The National Association of Pediatric Nurse Practitioners (NAPNAP) Acute Care Special Interest Group focuses specifically on acute care nurse practitioners.

The American Association of Nurse Practitioners (AANP) is a professional society for all specialties of nurse practitioner.

The Pediatric Nursing Certification Board (PNCB) Primary Care PNP Corner provides a wealth of information and collected links on continuing education, benefits, awards, and more for primary care nurse practitioners.

The National Association of Pediatric Nurse Practitioners (NAPNAP) is a professional society that caters specifically to pediatric specializations.

The American Association of Nurse Practitioners (AANP) is a professional society for all specialties of nurse practitioner.

The Bottom Line Acute care PNPs work with children who are at their most desperate and vulnerable moments. They take a focused approach, treating the specific and complex malady at hand. They contend with dynamic scenarios and high-intensity environments, providing critical care to immediate patient needs. Acute care PNPs stop the bleeding, both metaphorically and literally, and coordinate with patients, families, and primary caregivers to stabilize critical conditions and treat complex or chronic ailments. Primary care PNPs keep children as healthy as they can be. They take a holistic approach and a long-term view to patient care. They can often become a fixture in the life of the patient and that patient’s family, working not only with treatment, but also prevention strategies in order to establish healthy habits and avoid the need for acute care early in life. Primary care PNPs are both the first line of defense and the first point of contact for a patient on the journey from birth to young adulthood.