The impact of provider training on patient education for pediatric early food introduction.

BACKGROUND: Pediatric food allergies (FAs) present significant health and economic problems. Currently, there are no cures for FAs. Recent studies suggest that early introduction (EI), between 4 and 6 months of age, of commonly allergenic foods (CAFs) may reduce the risk of developing FAs. This contradicts the current standard of care, food avoidance. LOCAL PROBLEM: A federally qualified health center saw 894 patients aged 0-24 months during a 12-month period with only 18.9% receiving nutrition education. New dietary recommendations to prevent FA were not in place. METHODS: A retrospective chart review was used to evaluate use of an order set with patient education on EI to CAFs in the electronic medical record (EMR). INTERVENTIONS: Providers attended training on EI to CAFs and use of the EMR order set. Data were collected on the use of the order set over a 3-month period. RESULTS: Provider training significantly improved knowledge of FA as well as EI guidelines. After 3 months of implementation, 25.95% of eligible encounters contained the EI order set; 52% of patients received the order set during the measurement period. In the impact population, patients 4-12 months of age, 74.55% of patients received the order set. CONCLUSIONS: Evidence-based clinical content in EMR order sets coupled with provider training ensure clinical decision support in identifying, monitoring, and optimizing quality care standards.

CNS Melioidosis in a Traveler Returning from Cabo, Mexico.

Melioidosis is caused by the gram-negative bacillus Burkholderia pseudomallei, endemic to northern Australia and Southeast Asia. We present a patient who traveled to Mexico, returned to the United States, and developed progressive manifestations of melioidosis, culminating as central nervous system disease. Standard therapy was contraindicated, and a prolonged intensive phase was employed.

Building DNP Essential Skills in Clinical Data Management and Analysis.

Effectively teaching clinical data management and analysis in a doctor of nursing (DNP) program requires attention to developing skills that foster improvement at the bedside. The purpose of this article is to describe a DNP clinical data management and analysis course specific to translation and improvement in practice. The student evaluation scores are high; however, faculty evaluation identifies opportunities to improve translation and application at the point of the scholarly practice project.

Adolescent Psychosocial Assessment: The HEEADSSS.

Adolescence should be a time of healthy growth and development. Indeed, it is a critical period with significant physical, emotional, and mental changes. Despite robust physical health, adolescent risky behaviors may result in lifelong consequences as well as increased morbidity and mortality. The HEEADSSS review of systems is a tool to understand adolescent behavior and assess risk-taking behaviors to provide appropriate interventions. Using the HEEADSSS review of systems is an effective way to engage in dialogue with teens and address many of the challenges faced by this age group. [Journal of Psychosocial Nursing and Mental Health Services, 55(5), 24-27.].

Religion, spirituality, and older adults with HIV: critical personal and social resources for an aging epidemic.

By 2015, approximately half of adults with HIV in the United States will be 50 and older. The demographic changes in this population due to successful treatment represent a unique challenge, not only in assisting these individuals to cope with their illness, but also in helping them to age successfully with this disease. Religious involvement and spirituality have been observed to promote successful aging in the general population and help those with HIV cope with their disease, yet little is known about how these resources may affect aging with HIV. Also, inherent barriers such as HIV stigma and ageism may prevent people from benefitting from religious and spiritual sources of solace as they age with HIV. In this paper, we present a model of barriers to successful aging with HIV, along with a discussion of how spirituality and religiousness may help people overcome these barriers. From this synthesis, implications for practice and research to improve the quality of life of this aging population are provided.