Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

4-27-2017

Degree Program

Doctor of Nursing Practice

Degree Track

Family Nurse Practioner

Year Degree Awarded

2017

Month Degree Awarded

May

Keywords

abuse, childhood, primary care, adverse childhood experiences, advanced practice nurse, child trauma

Advisor Name

Karen

Advisor Last Name

Kalmakis

Capstone Chair First Name

Karen

Capstone Chair Last Name

Kalmakis

Capstone Member Name

Genevieve

Chandler

Capstone Outside Member Name

Wendy

Sargent

Abstract

Adverse childhood experiences (ACE) contribute to negative health outcomes. The impact of ACE is linked with physical, mental, and developmental disruption, increase in health-risk behaviors, and increased healthcare utilization. Approximately sixty percent of the US population reports a history of ACE. Despite this growing evidence that ACE is associated with health problems, primary care providers infrequently screen patients for ACE, nor do they consider the impact of ACE on health. The lack of routine screening for ACE in primary care represents lost opportunities to impact health outcomes and promote wellness. The overall goal of this project is to translate research to practice through screening for ACE in an adult primary care clinic. To accomplish this goal, brief interviews were conducted with 71 adult patients in a busy primary care clinic over a 4-week period. The ACE questionnaire, and a post-screening form were used to collect information about ACEs, patient responses, and follow-up recommendations. Descriptive statistics were used to calculate prevalence of ACEs, follow-up recommendations and patient responses to the screening intervention. Findings from the project demonstrated that high ACEs are associated with negative health outcomes and are linked with chronic health problems and increased healthcare utilization. Despite these associations very few patients were receiving counseling. ACE screening times took less time than anticipated and NP student interviewers felt comfortable and confident during the screening intervention. Findings support the need to screen for ACEs in primary care especially in patients with chronic disease.

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