A Closer Look: Nurse Competency and Emergency Department Pediatric Readiness
We asked pediatric emergency nursing and professional development expert, and long-time BCEN board of directors immediate past chairperson Rebecca Steinmann, MS, RN, CPEN, CEN, TCRN, CCRN, FAEN, to give an overview of the recent Journal of Emergency Nursing article, “Nurse Competency, Certification, and Continuing Education: Impact on EDs’ Pediatric Readiness,” and the significance of this first-of-its-kind research.
What follows is our exclusive interview with lead author Lisa M. Hill, DNP, RN, TCRN, EMT-P IC, Pediatric Trauma Coordinator, Department of Trauma Surgery, Henry Ford Health, Henry Ford St. John Hospital & Henry Ford St. John Children’s Hospital, and second author Robin Goodman, MSN, RN, CPEN, Project Manager, EMSC Innovation and Improvement Center, Site: The Lundquist Institute.
Why is this article and this original research significant?
Rebecca: The article highlights the importance of ongoing pediatric-specific preparation in improving the outcomes of our children. The reality that the vast majority of pediatric patients presenting for emergency care do not present to tertiary pediatric facilities necessitates that local general hospitals improve their capacity to care for this population.
Most institutions report that they require some type of nursing competencies and continuing education, however what that entails varies from place to place. Holding a nursing specialty certification defines that certificants have demonstrated a specific, standardized body of knowledge.
According to this study, emergency departments (EDs) requiring their nurses to obtain specialty certification demonstrated the highest weighted Pediatric Readiness scores. Providing emergency nurses with the resources to obtain specialty certifications such as their Certified Emergency Nurse (CEN) and Certified Pediatric Emergency Nurse (CPEN), ongoing pediatric education, and pediatric-specific nursing competencies contributes to higher quality care and improved outcomes.
Lisa and Robin, what prompted you and your co-authors to do this research? And now that the research is complete and the article has been published, what are you most excited about?
Lisa: For context, the average weighted score of the 2021 National Pediatric Readiness Project Assessment was only 69.5 out of 100. Although Pediatric Readiness depends on multiple factors to ensure Pediatric Readiness in an ED, we were curious as to what the role of pediatric continuing education, specialty certification, and competency played in the Pediatric Readiness score.
This research confirmed our suspicions that hospitals that require pediatric specific education, certification, and/or competency contribute to higher scores. It also provides evidence to hospital administrators that investing in their nursing staff to become certified, maintain pediatric competency, and/or obtain pediatric continuing education not only improves pediatric outcomes but decreases pediatric mortality. This was the first research project that was able to show this specifically for nursing.
Robin: The author group was aware that healthcare organizations have been cutting back on funding for staff training as a cost-saving measure. We aimed to determine whether pediatric-focused education, competency, and certification among nurses supported Pediatric Readiness in the emergency department. I was most excited about our findings, which show that investing in nurses’ pediatric expertise can directly improve Pediatric Readiness and pediatric patient care.
What would you like to highlight for the BCEN community at large about your research findings?
Lisa: It is important that any nurse who encounters pediatric patients needs to be prepared and confident in their ability, whether they are at a pediatric-specific ED or hospital, or a general ED. It can make a difference in the patient outcomes.
Robin: Our findings show that nurses with specialized pediatric expertise are essential for improving Pediatric Readiness, safety, and outcomes, especially in lower-volume emergency departments. Continuing pediatric-specific education, competency assessments, and specialty certification are critical for hospitals striving to reduce errors, enhance safety, and improve pediatric patient outcomes.
Is there anything you’d like to say to current and prospective CPENs?
Lisa: Thank you to those that have made the commitment to become CPEN-certified—it does make a difference in the care you provide to your patients. For those nurses who are contemplating becoming certified, do it!
Robin: For nurses who are already CPEN-certified, your commitment to pediatric excellence and support for your colleagues helps raise the standard of care for all children. For those not yet certified, pursuing the CPEN is a valuable way to strengthen your clinical expertise, build confidence, and foster a culture of safety and Pediatric Readiness in your emergency department.
What would you like to see happen next, and in the future, as far as Pediatric Readiness in the ED where nursing is concerned?
Lisa: I would like to see every hospital in the United States require mandatory pediatric continuing education, competency, and/or certification for nurses, as well as designating a nurse pediatric emergency care coordinator (PECC) in every ED.
Nurses are often the driving force for change, and I believe that supporting nurses to increase both their knowledge of, and comfort level with, pediatric patients will reduce unnecessary morbidity and mortality in pediatric patients—even in those hospitals that do not have a high volume of pediatric patients. Empowering nurses with the evidence that they make a difference in the outcomes of pediatric patients has been an amazing experience, and I am excited to see the results of the 2026 National Pediatric Readiness Project Assessment.
Robin: Nurses have long been a driving force behind Pediatric Readiness initiatives across the country. I want to see Pediatric Readiness become a more consistent priority in every emergency department. Structured competency assessments, dedicated education time, and strong nursing leadership are essential to support an emergency department’s Pediatric Readiness. Building and maintaining pediatric expertise among ED nurses should be recognized by all healthcare organizations as a critical element of quality and safety, not a discretionary effort dependent on funding.
We are truly proud of this work. ED nurses excel in advocating for and caring for their patients; we need similar advocacy for ED nurses’ needs in the workplace so we can consistently succeed and provide high-quality care.
How to Take the CPEN Exam
Ready to achieve the highest-level pediatric emergency nursing credential and get CPEN certified? Learn more about CPEN certification or contact BCEN.
