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The Peds NP: Pearls of Pediatric Evidence-Based Practice

The Peds NP: Pearls of Pediatric Evidence-Based Practice

Auteur(s): Becky Carson
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Join pediatric nurse practitioner and educator Dr. Becky Carson on The Peds NP, a podcast that turns evidence-based practice into practical, real-world strategies for caring for kids. Each episode blends the latest pediatric literature with conversational insights, helping you connect research to bedside decisions with confidence. Becky brings her experience as a dual-certified PNP in acute and primary care and faculty member at Duke University School of Nursing to guide you through cases, concepts, and clinical pearls that matter most. You’ll gain tools to improve outcomes, sharpen your thinking, and feel empowered in those tricky situations where judgment counts. Tune in, learn, and transform the way you practice—and remember, you’re doing it for the kids.



Disclaimers & Show Notes: www.thepedsnp.com

Copyright 2025 All rights reserved. Hygiène et mode de vie sain Troubles et maladies
Épisodes
  • Choosing Wisely Case 4: New onset enuresis (S12 Ep. 83)

    Choosing Wisely Case 4: New onset enuresis (S12 Ep. 83)
    Dec 1 2025
    Welcome to the Choosing Wisely Campaign series! This is the fifth and final episode of our 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures. Our last case-based episode focuses on a school-aged male presenting with new-onset enuresis. After a discussion of the differential diagnosis and evidence-based evaluation strategies, we apply recommendations from multiple AAP Choosing Wisely lists to create a care plan that is safe, resource-conscious, and child-centered. Throughout this episode, we’ll highlight how ethical care principles—beneficence, nonmaleficence, autonomy, and justice—guide high-value decision-making and help us avoid unnecessary imaging, laboratory studies, and interventions that add cost without improving outcomes. This familiar case in pediatrics is worthy of a rewind to relisten to a throwback episode that will reinforce your skills and emphasize the clinical diagnosis and management without added diagnostics, referrals, or medications. This case closes out our series on Choosing Wisely in Pediatrics, but the principles we’ve explored should continue to inform your practice every day. If you missed earlier episodes, rewind to learn more about the campaign’s background and listen to cases on fever and cough, gastroenterology presentations, and more. Series Learning Objectives: Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed. Modified rMETRIQ Score: 15/15 What does this mean? Competencies: AACN Essentials: 1: 1.1 g; 1.2 f; 1.3 d, e2: 2.1 d, e; 2.2 g; 2.4 f, g; 2.5 h, i, j, k7: 7.2 g, h, k9: 9.1i, j; 9.2 i, j; 9.3 i, k NONPF NP Core Competencies: 1: NP 1.1h; NP 1.2 k, m; NP 1.3 f, j, h2: NP 2.1 j, g; NP 2.2 k, n; NP 2.4 h, i; NP 2.5 k, l, m, n, o7: NP 7.2 m9: NP 9.1 m, n; NP 9.2 n; NP 9.3 p References: AAP Section on Emergency Medicine & Canadian Association of Emergency Physicians. (2022). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWEmergencyMedicine.pdf AAP Section on Gastroenterology, Hepatology, and Nutrition. (2023). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWGastroenterology.pdf AAP Section on Urology. (2022). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWUrology.pdf Daniel, M., Szymanik-Grzelak, H., Sierdziński, J., Podsiadły, E., Kowalewska-Młot, M., & Pańczyk-Tomaszewska, M. (2023). Epidemiology and Risk Factors of UTIs in Children-A Single-Center Observation. Journal of personalized medicine, 13(1), 138. https://doi.org/10.3390/jpm13010138 McMullen, P.C., Zangaro, G., Selzer, C., Williams, H. (2026). Nurse Practitioner Claims and the National Practitioner Data Bank: Trends, Analysis, and Implications for Nurse Practitioner Education and Practice. Journal for Nurse Practitioners, 22(1), p. 105569, https://doi-org.proxy.lib.duke.edu/10.1016/j.nurpra.2025.105569 Tabbers, M. M., DiLorenzo, C., Berger, M. Y., Faure, C., Langendam, M. W., Nurko, S., Staiano, A., Vandenplas, Y., Benninga, M. A., European Society for Pediatric Gastroenterology, Hepatology, and Nutrition, & North American Society for Pediatric Gastroenterology (2014). Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. Journal of pediatric gastroenterology and nutrition, 58(2), 258–274. https://doi.org/10.1097/MPG.0000000000000266 UCSF Benioff Children's Hospitals. (n.d.). Constipation & urologic problems. https://www.ucsfbenioffchildrens.org/conditions/constipation-and-urologic-problems Vaughan, D. (2015). The Challenger Launch Decision: Risky Technology, Deviance, and Culture at NASA. University of Chicago Press. DOI: 10.7208/chicago/9780226346960.001.0001 Wilbanks, Bryan A. PhD, DNP, CRNA. Evaluation of Methods to Measure Production Pressure: A Literature Review. Journal of Nursing Care Quality 35(2):p E14-E19, April/June 2020. | DOI: 10.1097/NCQ.0000000000000411
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    32 min
  • Choosing Wisely Case 3: Child with fever and cough (S12 Ep. 82)

    Choosing Wisely Case 3: Child with fever and cough (S12 Ep. 82)
    Aug 11 2025

    Welcome to the Choosing Wisely Campaign series! This is the fourth episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

    Our third case-based episode presents a child with fever and cough. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP’s Choosing Wisely Hospital Medicine and Infectious Diseases lists to create a resource-conscious care plan that is safe and patient-centered.

    In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

    Series Learning Objectives:

    1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
    2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
    3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

    Modified rMETRIQ Score: 14/15

    Competencies:

    AACN Essentials:

    • 1: 1.1 g; 1.2 f; 1.3 d, e
    • 2: 2.1 d, e; 2.2 g; 2.4 f, g; 2.5 h, i, j, k
    • 7: 7.2 g, h, k
    • 9: 9.1i, j; 9.2 i, j; 9.3 i, k

    NONPF NP Core Competencies:

    • 1: NP 1.1h; NP 1.2 k, m; NP 1.3 f, j, h
    • 2: NP 2.1 j, g; NP 2.2 k, n; NP 2.4 h, i; NP 2.5 k, l, m, n, o
    • 7: NP 7.2 m
    • 9: NP 9.1 m, n; NP 9.2 n; NP 9.3 p

    References

    ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

    American Academy of Pediatrics [AAP] Committee on Infectious Diseases & Pediatric Infectious Diseases Society. (2018). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWInfectiousDisease.pdf

    de Benedictis, F. M., Kerem, E., Chang, A. B., Colin, A. A., Zar, H. J., & Bush, A. (2020). Complicated pneumonia in children. Lancet (London, England), 396(10253), 786–798. https://doi.org/10.1016/S0140-6736(20)31550-6

    Kato, H. (2024) Antibiotic therapy for bacterial pneumonia. J Pharm Health Care Sci 10, 45. https://doi.org/10.1186/s40780-024-00367-5

    Schlapbach, L. J., Watson, R. S., Sorce, L. R., Argent, A. C., Menon, K., Hall, M. W., Akech, S., Albers, D. J., Alpern, E. R., Balamuth, F., Bembea, M., Biban, P., Carrol, E. D., Chiotos, K., Chisti, M. J., DeWitt, P. E., Evans, I., Flauzino de Oliveira, C., Horvat, C. M., Inwald, D., … Society of Critical Care Medicine Pediatric Sepsis Definition Task Force (2024). International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA, 331(8), 665–674. https://doi.org/10.1001/jama.2024.0179

    Smith, D. K., Kuckel, D. P., & Recidoro, A. M. (2021). Community-Acquired Pneumonia in Children: Rapid Evidence Review. American family physician, 104(6), 618–625.

    Society of Hospital Medicine, AAP, & Academic Pediatric Association. (2021). Five things physicians and patients should question. Retrieved from https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWHospitalmedicine.pdf

    Yun K. W. (2024). Community-acquired pneumonia in children: updated perspectives on its etiology, diagnosis, and treatment. Clinical and experimental pediatrics, 67(2), 80–89. https://doi.org/10.3345/cep.2022.01452
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    19 min
  • Choosing Wisely Case 2: Infant with diarrhea and dermatitis (S12 Ep. 81)

    Choosing Wisely Case 2: Infant with diarrhea and dermatitis (S12 Ep. 81)
    Jun 30 2025

    Welcome to the Choosing Wisely Campaign series! This is the third episode of a 5-part series exploring the ABIM Foundation’s Choosing Wisely Lists. This campaign aims to promote conversations between clinicians and patients to avoid unnecessary medical tests, treatments, and procedures.

    Our second case-based episode presents an infant with diarrhea and diaper dermatitis. After a clear discussion of the case and thoughtful consideration of the etiology and treatment strategies, we use the AAP’s Choosing Wisely dermatology and gastroenterology, hepatology, and nutrition lists to create a resource-conscious care plan that is safe and patient-centered.

    In the coming episodes, we’ll explore the pediatric lists and apply our knowledge to cases of common presentations seen in primary and acute care pediatrics.

    Series Learning Objectives:

    1. Introduction to the Choosing Wisely Campaign: Understand the origins, historical precedent, and primary goals of the campaign.
    2. Case-Based Applications: Explore five common presentations in primary and acute care pediatrics, applying concepts from various Choosing Wisely lists to guide management and resource stewardship.
    3. Effective Communication: Learn strategies for engaging in tough conversations with parents and colleagues to create allies and ensure evidence-based practices are followed.

    Modified rMETRIQ Score: 15/15

    Competencies:

    AACN Essentials:

    • 1: 1.1 g, 1.2f, 1.3de
    • 2: 2.1 de, 2.2g, 2.4fg, 2.5 hijk
    • 7: 7.2 ghk
    • 9: 9.1ij, 9.2ij, 9.3ik

    NONPF NP Core Competencies:

    • 1: NP1.1h, NP 1.2km, NP 1.3fjh
    • 2: NP2.1jg, NP2.2kn, NP 2.4hi, NP2.5 klmno
    • 7: NP7.2m
    • 9: NP9.1mn, NP9.2n, NP9.3p

    References

    ABIM Foundation. (2019). Communicating about overuse with vulnerable populations. Retrieved from https://www.choosingwisely.org/files/Communicating-About-Overuse-to-Vulnerable-Population_Final2.pdf

    AAP Section on Dermatology. (2021). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWDermatology.pdf

    AAP Section on Gastroenterology, Hepatology, and Nutrition. (2023). Five things physicians and patients should question. https://downloads.aap.org/AAP/PDF/Choosing%20Wisely/CWGastroenterology.pdf

    Harriet Lane Service (Johns Hopkins Hospital), Anderson, C. C., Kapoor, S., & Mark, T. E. (2024). The Harriet Lane handbook: a manual for pediatric house officers (23rd ed.). Elsevier.

    Jauregui, J., Nelson, D., Choo, E., Stearns, B., Levine, A. C., Liebmann, O., & Shah, S. P. (2014). External validation and comparison of three pediatric clinical dehydration scales. PloS one, 9(5), e95739. https://doi.org/10.1371/journal.pone.0095739

    Johnson, H., & Yu, J. (2022). Current and Emerging Therapies in Pediatric Atopic Dermatitis. Dermatology and therapy, 12(12), 2691–2703. https://doi.org/10.1007/s13555-022-00829-4

    Semon, A. K., Keenan, O., & Zackular, J. P. (2021). Clostridioides difficile and the Microbiota Early in Life. Journal of the Pediatric Infectious Diseases Society, 10(Supplement_3), S3–S7. https://doi.org/10.1093/jpids/piab063
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    26 min
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