Doctor of Nursing Practice (DNP) Projects
Access Control
Open Access
Embargo Period
6-18-2020
Degree Program
Doctor of Nursing Practice
Degree Track
Public Health Nurse Leader
Year Degree Awarded
2021
Month Degree Awarded
May
Keywords
screening, children, development, behavior, primary care
Advisor
Pamela Aselton
DNP Project Chair
Carrie-Ellen Briere
DNP Project Outside Member Name
Jameson Lassor
Abstract
Background: Children are a vulnerable population who are at risk for a variety of developmental, behavioral and family concerns. Early intervention leads to improved outcomes. By implementing the comprehensive evidence-based screening tool the Survey of Well-being for Young Children (SWYC), within a Federally Qualified Health Center (FQHC), outcomes for these children may be improved through early intervention.
Methods: The SWYC survey was provided to parents and guardians of children ages zero to five years at one pilot site at a FQHC in New England during well child visits (WCV) over a 6-week period. Implementation success was measured through review of electronic medical record (EMR) reports, tracking referrals, and an anonymous staff satisfaction survey.
Results: Chi-square analysis showed no significant difference between the pre-intervention and post-intervention groups developmental screening rate (p=.099) and referral rate (p=1.00). A significant difference (p=.017) was noted in completion of the M-CHAT between groups. The staff satisfaction survey had an estimated responses rate of 50%. Responses indicated that 40% of staff were satisfied with the SWYC survey, 50% were neutral, and 10% were unsatisfied.
Conclusion: Findings from the QI project indicate that the sample size may have been too small to see a difference between the pre-intervention and post-intervention groups. M-CHAT rates may have been lower during the QI project because the POSI found within the SWYC survey also screens for autism. An emerging theme was that the SWYC had a greater focus on family concerns when compared to the previous tool used in this FQHC. Recommendations for the future include a larger sample size and higher engagement of clinical staff during pilot project planning.
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