OBJECTIVES:

The objective of the study was to examine the Parenting Support Needs Assessment (PSNA) for content validity, internal consistency reliability, and clinical usefulness. The PSNA was designed for use by primary care clinicians who care for young children and their families, to identify families with risk factors for child maltreatment.

METHODS:

Phase I of the study consisted of the content validity assessment by child maltreatment experts, and phase II was a pilot test of the PSNA and referral algorithm by nurse practitioners (NPs) for clinical usefulness. Data obtained during the pilot testing were used to examine individual PSNA items, establishing an estimate of internal consistency reliability and identify the instrument's clinical usefulness.

RESULTS:

The PSNA instrument and referral algorithm was found to have content validity and clinical usefulness. The number of referrals to family support social service agencies increased from 4 to 22 over the pre-PSNA use (with different children) and the instrument exceeded the internal consistency reliability threshold of .80.

CONCLUSIONS:

The PSNA instrument was found to be valid, reliable, and clinically useful in the primary care setting. The PSNA represents a significant step forward in screening for child maltreatment risk in families of young children during routine primary care.

INTRODUCTION:

A quality improvement project was undertaken to determine if an evidence-based educational brochure and reminder system can increase human papillomavirus (HPV) vaccine uptake and dose completion rates.

METHOD:

Development of a brochure to promote HPV vaccine uptake was based on predictors of parental acceptance and Health Belief Model concepts. Electronic alerts prompted telephone reminders for dose completion. This quality improvement project utilized a quasi-experimental design with 24 parents of preteen girls from a private pediatric practice and a historical control group of 29 parents. HPV vaccine rates were compared between the groups.

RESULTS:

A significant difference in HPV vaccine uptake (χ(2) = 11.668, P = .001; odds ratio [OR] = 9.429, 95% confidence interval [CI] = 2.686-33.101) and dose completion (χ(2) = 16.171, P < .001; OR = 22.500, 95% CI = 4.291-117.990) rates were found between the historical control and intervention groups. Parents who received the clinical protocol were 9.4 times and 22.5 times more likely to have HPV vaccine uptake and dose completion, respectively.

DISCUSSION:

Low national HPV vaccine rates demonstrate the need for theory-based vaccine delivery programs. These results show that an evidence-based educational brochure and reminder system appeared to improve HPV vaccine uptake and dose completion rates at this private pediatric practice.

OBJECTIVE:

The goals of this study were to evaluate the effectiveness of an inpatient documentation system for identifying missed vaccine opportunities and to identify parental satisfaction with their vaccination services.

METHODS:

A prospective descriptive study compared inpatient documentation of vaccine history with actual vaccine records, and adherence with the Advisory Committee on Immunization Practices guidelines was assessed. A parental satisfaction survey was administered.

RESULTS:

One hundred sixty pediatric patients ages 2 months to 17 years (mean age 8 years) were enrolled. Seventy-six percent of patients had documentation of vaccine history, and 92% were documented as receiving all age-appropriate vaccines. Actual immunization records showed that 16% percent of patients were in compliance with Advisory Committee on Immunization Practices guidelines. The most commonly missed vaccine was influenza (67%) followed by meningococcal (57%), hepatitis A (48%), and varicella (38%). Ninety percent of parents were satisfied with the vaccination services their child had received.

CONCLUSION:

A review of vaccine records is recommended to accurately assess status. Inpatient hospitalization represents an opportunity to assess vaccination status, address parental concerns, and provide updated vaccinations.

INTRODUCTION:

Twenty-three percent of preschoolers are overweight/obese, which puts these children at risk for the development of chronic health comorbidities. The purpose of this randomized control pilot study was to determine the feasibility and preliminary effects of a theoretically based, primary care intervention on the physical outcomes of 60 overweight/obese preschool/early school-aged 4- to 8-year-old children.

METHODS:

After recruitment and baseline assessment, parent-child dyads were randomly assigned to either the treatment or the control condition. Four intervention sessions were conducted with the parents in their child's primary health care office. The impact of the intervention was evaluated by assessing child anthropometric measures (e.g., waist, waist-by-height ratio, and body mass index [BMI]) immediately, 3 months, and 6 months after the intervention period.

RESULTS:

Analysis of variance models suggested that children in the experimental group were found to have reduced waist circumference and waist-by-height ratio immediately after the intervention that persisted for 3 and 6 months (f = 0.33, 0.35, respectively). BMI and BMI percentile were not differentially affected.

DISCUSSION:

These promising findings suggest that a primary care-based, parent-focused overweight/obesity treatment program is feasible and demonstrated positive preliminary effects, improving the children's overall health trajectory.

Recent reports describing a rise in serious allergies and life-threatening reactions have prompted the need for pediatric nurse practitioners to re-evaluate and hone their clinical skills with regard to the recognition of anaphylaxis. An accredited symposium entitled, "Anaphylaxis in the Pediatric Patient: Optimizing Management and Prevention" was held in conjunction with the 2012 Annual Conference of the National Association of Pediatric Nurse Practitioners. This article is an accredited enduring activity from that symposium. Goals of this activity are to (a) provide participants with information regarding current trends in serious allergies and anaphylaxis, (b) discuss recommendations from clinical guidelines designed to standardize practice, and (c) address medical and educational needs of patients with anaphylaxis. This article focuses on the point of care where pediatric nurse practitioners require the diagnostic skills to determine whether a patient's acute symptoms are consistent with a diagnosis of anaphylaxis and whether epinephrine should be used to treat those symptoms. The rationale for the use of intramuscular epinephrine, insights into the development and execution of an emergency action plan, and patient education also are discussed.