Kayla Curiel, DNP, APRN, CPNP

Member Since: 
2008
State: 
Missouri

In your opinion, which new trends are the most impactful in today’s pediatric health care world?  

One of the newest, exciting, and most impactful trends in today’s pediatric health care world is telemedicine. Telemedicine is a great way to provide care in rural, medically underserved areas. Currently, I work with medically complex patients who drive a significant distance several times per month to see our multidisciplinary specialty team. In addition to our clinic patients, we also have patients who are admitted to smaller, local hospitals that are generally transferred due to the need for our expertise in caring for this patient population. Telemedicine is a great opportunity to provide care for those patients not only on an outpatient basis, but also as a consultation service to the local hospitals where they may be admitted. While, there will be times that a visit or an admission to the specialty clinic or hospital is warranted, if we are able to reduce the amount of visits and/or transfers, this would not only provide financial savings, but would also improve patients and family satisfaction and quality of life. Multiple studies have reported that parents and local providers have high satisfaction with subspecialty telemedicine consultations and visits.

How can NAPNAP members not only prepare for these trends but also serve as health care leaders in light of them?

As Pediatric Nurse Practitioners (PNPs) we need to push our institutions to consider the use of telemedicine to provide care for our patients that have multiple barriers when seeking care. In addition, we need to be advocates for reimbursement for PNPs to provide this needed method of care. Our patients are already vulnerable due to their dependence on others to get the care that they need. If you add a chronic illness in a rural, medically underserved area, that vulnerability only increases. As advocates for our patients, telemedicine should be a trend that every PNP should not only be utilizing but leading the charge for other providers and institutions. Those who care for vulnerable and underserved patient populations should be invested in providing this care. 

What motivated you to start the Gastroenterology SIG?

Pediatric gastroenterology is an area that encompasses primary, specialty, and acute care practices. I currently work in gastroenterology with a focus on intestinal rehabilitation, nutrition support and enteral access. This patient population includes pediatric patients of all ages that receive parenteral nutrition, have lost small or large bowel, and/or need enteral nutrition to meet their nutritional needs. Prior to working in gastroenterology, I practiced in pediatric primary care and pediatric acute care. Many of the issues that are seen in gastroenterology can be addressed without a referral to our clinic. For many families, this is a regional center requiring travel anywhere from a few hours to 6-8 hours to see a gastroenterology provider. Even in the specialty that I work, I rely heavily on my patients’ primary care provider and/or acute care teams to care for these patients due to distance, transportation needs, etc. Creating a SIG specific to gastroenterology will promote networking to further the knowledge and education needed to provide quality care in this area. The SIG will allow for exchange of information on new evidence-based practice recommendations for this specialty as well as the exchange of information. This can improve not only multidisciplinary care clinics recommended in many of the sub-specialty areas within gastroenterology, but for primary and acute care providers in the community as well. Currently, there are no specific gastroenterology resources through NAPNAP even though it is a topic that is important to many aspects of pediatric general and acute care. 

What do you hope the group accomplishes over the next year?

The most important goal of this group is to provide general resources for PNPs, practicing in many settings, giving them the tools to care for pediatric gastroenterology patients. PNPs are instrumental in caring for pediatric patients in the community as well as patients in acute care and in gastroenterology. One of the goals is to publish a reference care for the failure to thrive work up and a reference card for gastrostomy tube assessments. Many times, patients can be screened and even treated by primary care providers in the community for these two common issues without a need for a referral for specialty care. Additionally, we would like to start an online journal club that would be held quarterly where members could log on and read and/or listen to discussions on recent publications for evidence-based practice in pediatric gastroenterology. Eventually, we would like to have sub-groups within the SIG with champions for each of those sub-groups. Gastroenterology is a large specialty that includes not only general gastroenterology (constipation, diarrhea, failure to thrive, abdominal pain, etc.), but also inflammatory bowel disease, nutrition support (both enteral and parenteral), intestinal rehabilitation, hepatology, etc. The SIG has the ability to involve most, if not all, NAPNAP members and we are excited to get started.

How do you manage your professional association volunteerism while maintaining a busy schedule?

In healthcare today, all of us are being asked to do more with less whether that is resources or time. Understanding this and working with the system instead of fighting it is key. Whether it is working on professional association volunteerism, quality improvement, research, program development, etc. professional development outside of clinical care is important to not only make you a well-rounded PNP, but also to improve your long-term career satisfaction. If you make this a priority just as you do clinical care, time is usually available somewhere within your busy schedule.

When you’re not being a rockstar pediatric-focused APRN, what do you enjoy doing?

My husband and I love to travel and hike in our free time, however, this has been in short supply this year. We are currently expecting our first child this summer! I have finally come to terms with being an “advanced maternal age (AMA)” mother and I am embracing it. We are excited for her arrival and plan on taking her on short hikes this fall. Also, we are big Kansas City Chief’s football fans, however she may have to wait a year to go. Arrowhead is the loudest stadium in the NFL, which my PNP-self tells me would not be good for her long-term hearing 

Home Town: 
Wheatland, MO