Improving Pediatric Primary Care Universal Lipid Screening in 9-11-year-olds

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The Ohio State University

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Cardiovascular disease is the leading cause of death in the United States and is linked to childhood dyslipidemia. 30-60% of childhood dyslipidemia cases are missed due to lack of universal screening. In 2011, the National Heart Lung Blood Institute (NHLBI) lipid screening guidelines were updated to include universal screening in 9–11-year-olds. The American Academy of Pediatrics (AAP) endorsed these guidelines in 2014 and added them to the Bright Futures recommendations. At the project site, the primary care providers (PCPs) were not aware of the universal lipid screening guidelines and not performing childhood lipid screening as indicated by the NHLBI and AAP. The purpose of this EBP project was to increase provider adherence with NHLBI and AAP Bright Future's recommended universal lipid screening guidelines during 9–11-year-old well child visits to identify dyslipidemia and potentially reduce future risks and complications of heart disease. An Advanced Practice Registered Nurse (APRN) conducted a quality improvement (QI) project utilizing the plan, do, study, act model to improve PCPs' knowledge and adherence to ordering universal lipid screening at 9-11 year well child visits (WCV). The primary care providers completed a knowledge survey and attended an educational in-service. Criteria for adherence to the guidelines included documentation of correct diagnosis code with an associated lipid profile order. Results of the QI project demonstrated 1) an improvement in baseline knowledge regarding the universal lipid screening guidelines and 2) an increased ordering rate of universal lipid screenings baseline of 0.5% to 82% by the end of the second month of data collection. Findings support in-service as a mode to support primary care staff to improve adherence to NHLBI universal lipid screening guidelines.



child, United States, dyslipidemia, quality improvement, primary health care, documentation, pediatrics, education, screening