Year of Publication

2019

Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Sharon E. Lock

Clinical Mentor

Dr. Melissa Wright

Committee Member

Dr. Judith Daniels

Abstract

Purpose: High cholesterol levels have been directly linked to atherosclerosis, which is a leading cause of cardiovascular disease (CVD). Risk factors that accelerate the development of atherosclerosis, such as high cholesterol can begin in childhood. The purpose of this project was to evaluate provider adherence to the National Heart, Lung, and Blood Institute’s (NHLBI) Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents, specifically the guidelines on universal lipid screening in children aged 9-11 years. The objectives were: 1) determine the rate of lipid screening in children 9-11 years old; 2) determine the number of children who meet the criteria for the diagnosis of dyslipidemia; and 3) determine the method of treatment of children diagnosed with dyslipidemia.

Method: The setting was a pediatric clinic in a large healthcare organization in the Midwest. A retrospective chart review was performed on 97 randomly selected charts of patients ages 9 to 11 years old who were seen in the clinic for a well­-child exam from February 1, 2018 through July 31, 2018.

Results: The majority of patients were 11 years old (49.5%), male (55.7%), and white (84.5%). Providers ordered lipid panels 47.4% of the time. Abnormal results were found in 44.2% of patients and additional testing was ordered in 26.3% of those patients which were outside recommended guideline parameters. No patients met the criteria for a diagnosis of hypercholesterolemia according to the guideline recommendations.

Conclusion: Providers in this clinic were not consistently following recommended NHLBI guidelines regarding lipid panel screening in the pediatric population. Providers were more likely to perform lipid panels on patients who are 11 years old and male. There is an opportunity to improve lipid screening rates in the pediatric population in an effort to prevent the development of cardiovascular disease in later life. Educating providers on the NHLBI’s recommended guidelines for practice may improve screening rates and identification of those at risk.

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