The coronavirus disease 2019 (COVID-19) pandemic affects all aspects of healthcare. The pressures to provide safe acute care for all ages has created a need for pediatric facilities to expand the age range of patients into young adulthood in order to free space in adult facilities for older patients.

The National Association of Pediatric Nurse Practitioners (NAPNAP) published its Position Statement on Age Parameters for Pediatric Nurse Practitioner Practice in 2019, noting that historically pediatric nurse practitioners (PNPs) cared patients from birth to 21 years of age. Of note, the 2019 statement expanded PNP practice to include “in specific situations based on patient needs, individuals older than 21 years can continue to receive health care from PNPs until care can be successfully transitioned to adult health care providers.” NAPNAP’s statement is consistent with the American Academy of Pediatrics’ statement regarding the upper age limits of pediatric care extending beyond age 21 years of age based on needs of the individual patient and the training, abilities and interests of the provider.

During the COVID-19 pandemic, NAPNAP recognizes that PNPs may be called upon to care for young adults with acute health care needs that must be met. NAPNAP stands by its age parameters statement that PNPs may care for young adults older than 21 years of age with the understanding that: (a) individual state nurse practice acts are consulted and followed; (b) the PNP has received the education and training to care for the patient; (c) safe harbor protections are in place to protect PNPs from being forced to accept an unsafe patient assignment because of their lack of training or education to care for the patient; and (d) care for the young adult patient will transition to an adult provider as soon as it is safe to do so.