Jennifer Coddington

Paternal Postpartum Depression: What Health Care Providers Should Know

Paternal postpartum depression (PPD) is a clinically significant problem for families that is currently underscreened, underdiagnosed, and undertreated. Maternal PPD is a well-known condition and has been extensively researched. In comparison, PPD in fathers and its potential effects on the family are not widely recognized. Studies have shown the importance of optimal mental health in fathers during the postpartum period. Negative effects of paternal PPD affect marital/partner relationships, infant bonding, and child development. To promote optimal health for parents and children, pediatric nurse practitioners must stay up to date on this topic. This article discusses the relationship of paternal PPD to maternal PPD; the consequences, signs, and symptoms; and the pediatric nurse practitioners role in assessing and managing paternal PPD.

Quality of health care provided at a pediatric nurse-managed clinic.

Purpose: The purpose of this study is to assimilate evidence regarding quality of care received at nurse‐managed clinics (NMCs), particularly a pediatric NMC that provides health care for the underserved pediatric population. Data sources: A nonexperimental design was used in this study. Quality of care data were collected at Trinity Nursing Center for Child Health (TNCCH), a pediatric NMC. Evidence included whether a pediatric NMC met selected national benchmark pediatric Healthcare Effectiveness and Data Information Set (HEDIS) quality indicators as well as HEDIS targets set by the Office of Medicaid Policy and Planning (OMPP) in Indiana. Conclusions: Findings suggest that TNCCH met or exceeded national HEDIS benchmark standards of care and targets set by OMPP. This study offers further evidence that NMCs provide a high quality of care. Implications for practice: Benefits of addressing the research question in this study include the preservation of the nurse‐managed healthcare safety net, increased access to health care for the medically underserved population resulting in improved health outcomes, and evidence to suggest that NMCs can assist private practice physicians to support this population of patients.

Parental Opioid Abuse: Barriers to Care, Policy, and Implications for Primary Care Pediatric Providers

Parental opioid use is affecting the physical, developmental, and mental health of the pediatric population nationwide and raises questions of safety when these children remain in the care of opioid-addicted parents. Pediatric providers face many barriers to identifying and caring for children beyond the neonatal period who have been affected by parental opioid abuse both in utero and in the home. These barriers include communication between providers and services, identification of intrauterine exposure, parental opioid abuse screening, and knowledge of child protective services involvement. In addition, understanding current state and national health policy regarding parental opioid abuse helps providers navigate these barriers. The purpose of this article is to identify barriers to care of children affected by parental opioid abuse both in utero and in the home, to discuss current health policy surrounding the issue, and to identify implications for the care of these children in the primary care pediatric setting.

Child Passenger Safety Policy and Guidelines: Why Change Is Imperative.

Despite dramatic advances in child passenger safety during the past decade, motor vehicle collisions (MVCs) remain the leading cause of unintentional injury deaths for children ages 1 year and older (Centers for Disease Control and Prevention [CDC], 2010). The risk of injury or death related to MVCs increases as the child ages, which is attributable to lower rates of child safety restraint use (Yingling, Stombaugh, Jeffrey, LaPorte, & Oswanski, 2011). It has been found that children ages 4 to 8 years have the lowest rates of child safety restraint use, ranging from 36% to 43% (Yingling et al., 2011).

Hypoplastic Left Heart Syndrome: Parent Support for Early Decision Making

Hypoplastic left heart syndrome is a life threatening congenital cardiac anomaly. After a child has been diagnosed with hypoplastic left heart syndrome, parents must make life or death decisions within days of birth. Healthcare providers must provide appropriate education so that parents are able to make informed, timely decisions. Information regarding the diagnosis, treatment options, and parental decision making process for initial decision making for hypoplastic left heart syndrome are provided to guide nurses who work with these families. The challenging decision making process that parents must go through after diagnosis of hypoplastic left heart syndrome will be described.

Factors Related to Healthy Siblings' Psychosocial Adjustment to Children With Cancer: An Integrative Review.

Purpose: To identify factors related to the psychosocial adjustment of healthy siblings of children with cancer (HSCC). Design and Method: An integrative review was conducted. Controlled vocabularies relevant to siblings, pediatrics, children, neoplasms, and psychosocial adaptation were used to search Cumulative Index to Nursing & Allied Health Literature and PubMed. Articles that met inclusion criteria (eg, quantitative studies related to HSCC’s psychosocial adjustment; had sample sizes of at least 30; and HSCC age between 1 and 19 years) were reviewed. Key findings of selected articles were analyzed according to sibling characteristics, social support, and contextual factors. Results: Seven nonexperimental and 5 quasi-experimental studies were reviewed. HSCC’s characteristics (eg, age, gender), perceived social support from family and summer camp, and perceived contextual factors (eg, role overload, family adaptability) were significant factors that correlated with HSCC’s psychosocial adjustment. Conclusion: When caring for a child diagnosed with cancer, nurses need to include HSCC in the assessment of a family unit’s adaptation to cancer distress and provide appropriate interventions to promote HSCC’s psychosocial well-being.

Implementing family-based childhood obesity interventions

Family-based interventions have been effective in managing childhood obesity, and pediatric nurse practitioners (PNPs) are positioned to provide obesity interventions in both patient and family primary care settings. The purpose of this article is to guide the PNP in implementing family-based childhood obesity interventions, including identification, diagnostic evaluation, and management.

Depression in the School-Aged Child With Type 1 Diabetes: Implications for Pediatric Primary Care Providers

Depression is a common comorbid condition experienced by children with type 1 diabetes that, if undiagnosed, can lead to deterioration in glycemic control and other serious health complications. Although it is documented that children with type 1 diabetes experience high rates of depression, a comprehensive clinical guide does not exist to help direct the pediatric provider on how to best care for these children. The purpose of this article is to synthesize current evidence to aid the pediatric primary care provider in the detection and management of depression in the school-aged child with type 1 diabetes.

Separation Anxiety Disorder in School-Age Children: What Health Care Providers Should Know

Separation anxiety disorder (SAD) is the most common childhood anxiety disorder, and it has many consequences, particularly for school-age children. These consequences include excessive worry, sleep problems, distress in social and academic settings, and a variety of physical symptoms that, left untreated, can cause social and academic decline. Pediatric providers routinely see children in the primary care office and have the unique opportunity to diagnose, treat, and manage children with SAD. Despite this, SAD continues to be underdiagnosed and undertreated because of a gap in the literature regarding evidence-based practice guidelines for pediatric providers. The purpose of this article is to discuss the diagnosis and management of SAD in school-age children and highlight the role of pediatric providers in managing separation anxiety.

Increasing Colorectal Cancer Screening Using a Quality Improvement Approach in a Nurse-Managed Primary Care Clinic

Abstract: According to the American Cancer Society, 1 in 23 Americans will be diagnosed with colorectal cancer (CRC) in their lifetime. Screening for CRC is an effective, yet underused preventive approach. This is especially true in rural areas, where only 35% of patients were found to be up to date on their screenings in 2014. Increasing CRC screening can produce positive patient outcomes by early recognition and removal of precancerous polyps. The purpose of this project was to use quality improvement (QI) interventions to increase CRC screening rates at a nurse-managed clinic in rural Indiana. Using Demings Plan-Do-Study-Act QI model, multiple interventions were implemented which resulted in a 37% increase in the number of screenings ordered on eligible patients and an overall increase of 28% in the completion of the screenings. This project contributes to healthcare quality knowledge by also suggesting that the fundamental principles of encouraging staff feedback to gain buy-in, improving processes informed by patient data, and valuing frequent performance feedback to staff, strengthened this QI project and ensured adoption and sustainability of these results.