The role of the advanced practice provider in pediatric urology: A census of the pediatric urology nurses and specialists (PUNS).

BACKGROUND: The prevalence of pediatric chronic conditions and demand for lower urinary tract symptom management have risen in recent decades, contributing to growing clinical demand for pediatric urology services. Meeting this demand requires a sufficient and well-supported workforce, and Advanced Practice Providers (APPs) have become an increasingly recognized component of urological care delivery. The Pediatric Urology Nurses and Specialists (PUNS) organization represents APPs in pediatric urology in the United States and Canada. This study aimed to conduct a census survey of PUNS members to better understand APP education and roles in pediatric urology. STUDY DESIGN: This descriptive survey, developed by the PUNS research special interest group, was administered to PUNS fall meeting attendees in 2023. The electronic survey collected information on demographics, professional settings, the degree of independence in practice versus physician-supervised roles, procedures, and diagnoses managed, and engagement in research. RESULTS: There were 112 of 300 respondents (37%), predominantly female (97.9%). 46.3% were between 31 and 40 years, followed by the 41-50 years group (27.4%), those aged 51 years and older (15.8%), and the 20-30 years (10.5%). 90% of the respondents work in urban centers, with 98.7% based in university settings or academic institutions. Respondents held advanced degrees, including a Master of Science in Nursing (MSN) (71.4%), a Doctor of Nursing Practice (DNP) (9.8%), and a Doctor of Philosophy (PhD) (1.8%). Most respondents evaluate patients independently of physicians (94.7%). 58% were involved in research through their roles, 24.1% assisted with patient recruitment and consent, another 24.1% were co-investigators, 8.9% were primary investigators, and 8.9% of respondents had published in peer-reviewed journals over the past two years. DISCUSSION: APPs reported independently managing most pediatric urology conditions, with many also performing procedures independently. APPs are also involved with research activities to various degrees. This information can be used to improve APP utilization internationally, fully optimizing their practice scope and improving surgeon time utilization. CONCLUSION: This survey revealed a well-educated, predominantly female membership primarily working in urban academic environments and exhibiting high clinical independence. Less than half of the membership participates in research; those who do are significantly involved across various capacities.