Effectiveness of the Pediatric Nursing Excellence Model on Nurses’ Knowledge and Practice in Pediatric Orthopedic Surgery Care: A Randomized Controlled Trial

Background: Pediatric orthopedic nursing requires specialized competencies to optimize
patient outcomes, particularly in the complex realm of pediatric surgery. This study explores the
effectiveness of the Pediatric Nursing Excellence (PNE) Model in enhancing nurses’ knowledge and
clinical practice in providing perioperative care for pediatric orthopedic patients in tertiary care
inpatient settings. Methods: A double-blind, randomized controlled trial was conducted from February
to July 2024, involving 100 nurses from two tertiary care hospitals in Tanta, Egypt. Participants
were randomly assigned to receive PNE Model training (n = 50) or routine care (n = 50). Nurses’
knowledge, practical skills, and adherence to PNE principles were assessed at baseline, immediately
post-intervention, and after one, three, and six months using validated tools. Results: The intervention
group showed significantly greater improvements in knowledge (20.62 ± 6.7 vs. 8.16 ± 5.5,
p < 0.001) and practice scores (62.28 ± 4.1 vs. 40.06 ± 14.7, p < 0.001) post-intervention, sustained
over six months. Path analysis revealed that the PNE Model enhanced nursing practice directly
(β = 0.25, p < 0.001) through improvements in engagement and adherence to excellence principles
and indirectly (β = 0.53, p < 0.001) by significantly enhancing nurses’ knowledge (β = 0.70, p < 0.001),
which in turn positively influenced their clinical practice (β = 0.75, p < 0.001). Post-intervention,
82% of nurses in the intervention group achieved high levels of professional excellence, compared
to 8% at baseline (p < 0.001). Conclusions: The PNE Model demonstrates robust effectiveness in
enhancing nurses’ knowledge, clinical practice, and professional excellence in pediatric orthopedic
surgery care, with sustained long-term benefits. This evidence supports implementing specialized
nursing education models to improve pediatric care quality in orthopedic settings.