Download or read book Improving Lead Screening in a Pediatric Practice written by and published by . This book was released on 2019 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt: Abstract Background: Detectable lead levels in children's blood have been associated with increased cognitive difficulties, attention deficits, and poorer academic performance. Children enrolled in Medicaid have higher rates of elevated blood lead levels, yet requirements to test all children at age 1 and 2 who are enrolled in Medicaid are not being met. Nationally, 34% of children enrolled in Medicaid do not undergo proper blood lead level screening. The aim of this project was to increase required blood lead level screening rates for children with Medicaid insurance at a private pediatric practice in the Shenandoah Valley in Virginia. Methods: The Institute for Healthcare Improvement (IHI) Model for Improvement was used to guide this practice improvement. This model stresses the importance of performing a needs assessment, establishing a baseline, and tracking balancing measures to ensure the intervention has no unintended consequences. A baseline rate of screening was collected by retrospective chart review, a physical review of the clinic was performed, and staff interviews were conducted. The Plan, Do, Study, Act (PDSA) cycle was the used to implement the intervention. Run charts were displayed weekly to show progress. Intervention: Three cycles of the interventions were run. The first intervention was an inservice to update staff to the current guidelines. Second, an official policy change was enacted, and finally an electronic health record (EHR) flag was employed as a reminder. Results: The initial assessment revealed that blood lead screenings were not being conducted on 2-year-old children enrolled in Medicaid. Interventions to change the practice and screen 2-year-old children enrolled in Medicaid were designed based on a search of the literature. The IHI Model for Improvement produced statistically significant improvement (p

Download or read book Improving Childhood Blood Lead Level Screening Reporting and Surveillance in Allegheny County Pennsylvania written by Donna Keyser and published by Rand Corporation. This book was released on 2006 with total page 61 pages. Available in PDF, EPUB and Kindle. Book excerpt: Lead poisoning remains a serious, preventable environmental health threat to young children, and its elimination is a key goal of U.S. public health policy. This report focuses on screening, reporting, and surveillance of childhood blood lead levels in Allegheny County, Pennsylvania, through a review of relevant literature, state and county reporting and surveillance databases, and interviews and focus groups.

Download or read book Barriers to Lead Screening Among Pediatric Providers in King County WA written by Alexandra Perkins and published by . This book was released on 2019 with total page 38 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pediatric care guidelines recommend assessment of children for lead exposure during routine child care in the first two years of life. In Washington State, pediatric lead screening rates are among the lowest in the nation. This investigation sought to describe pediatric lead screening practices and barriers in King County, WA. King County providers were invited to complete a web-based survey regarding their lead screening practices between October 2018 and April 2019. Follow up semi-structured interviews (SSI) were conducted with 13 volunteer respondents. Respondents were characterized as high versus low screeners based on responses. Reported knowledge, practice, and barriers were compared for the two groups. Grounded theory methodology was used to identify provider attitudes and practices from SSIs. 246 providers who saw patients under the age of 6 years participated in the survey. Sixty six percent agreed or strongly agreed with the statement "Primary care for all children aged 12 to 24 months in King County should include a lead exposure history," while only 39% reported always conducting a lead exposure history at least once during early childhood visits. Lower frequency screeners were more likely to report uncertainty about when to perform an exposure history and when to order a blood lead test. They were also more likely to report lack of a clinic system or policy to prompt them to conduct an exposure history. SSIs revealed a large variety in practices and barriers between clinics, suggesting that it will require a number of strategies to increase lead screening rates in King County. Strategies to improve lead screening rates in this community should include provider education on recommended screening practice, promoting standardized clinic policies, and working to partner with other early childhood development initiatives to promote lead screening, such as building collaborations with Early Head Start programs.

Download or read book Physician Opinions and Practices Regarding Childhood Lead Screening written by Dennis John Kuo and published by . This book was released on 1998 with total page 160 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book An Ounce of Prevention written by and published by . This book was released on 2005 with total page 28 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Childhood Lead Poisoning Prevention written by Lydia Rice and published by . This book was released on 2019 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: Exposure to lead can lead to detrimental effects, especially in children. To reduce effects of lead exposure and improve screening practices among primary care providers, the Centers for Disease Control (CDC) created recommendations for childhood lead poisoning prevention. The researchers in this study utilized a descriptive, non-experimental, quantitative design to determine primary care providers' knowledge and practices regarding childhood lead poisoning prevention. The researchers developed a questionnaire that was placed into SurveyMonkey for online distribution via email and social media. The researchers utilized the most recent CDC recommendations regarding childhood lead poisoning prevention to create the questionnaire. The population surveyed were primary care providers who practice in the state of Mississippi. Data analysis revealed that primary care providers were not knowledgeable of CDC recommendations for lead level screening in children. Findings revealed a great need for further education regarding lead screening guidelines and implementation of the guidelines among primary care providers in Mississippi.

Download or read book Recommendations for Blood Lead Screening of Medicaid eligible Children Aged 1 5 Years written by Mary Jean Brown and published by . This book was released on 2009 with total page 13 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Lead is a potent, pervasive neurotoxicant, and elevated blood lead levels (EBLLs) can result in decreased IQ, academic failure, and behavioral problems in children. Eliminating EBLLs among children is one of the 2010 U.S. national health objectives. Data from the National Health and Nutrition Examination Survey (NHANES) indicate substantial decreases both in the percentage of persons in the United States with EBLLs and in mean BLLs among all age and ethnic groups, including children aged 1-5 years. Historically, children in low-income families served by public assistance programs have been considered to be at greater risk for EBLLs than other children. However, evidence indicates that children in low-income families are experiencing decreases in BLLs, suggesting that the EBLL disparity between Medicaid-eligible children and non-Medicaid-eligible children is diminishing. In response to these findings, the CDC Advisory Committee on Childhood Lead Poisoning Prevention is updating recommendations for blood lead screening among children eligible for Medicaid by providing recommendations for improving BLL screening and information for health-care providers, state officials, and others interested in lead-related services for Medicaid-eligible children. Because state and local officials are more familiar than federal agencies with local risk for EBLLs, CDC recommends that these officials have the flexibility to develop blood lead screening strategies that reflect local risk for EBLLs. Rather than provide universal screening to all Medicaid children, which was previously recommended, state and local officials should target screening toward specific groups of children in their area at higher risk for EBLLs. This report presents the updated CDC recommendations and provides strategies to 1) improve screening rates of children at risk for EBLLs, 2) develop surveillance strategies that are not solely dependent on BLL testing, and 3) assist states with evaluation of screening plans."--P. 1.

Download or read book Practices and Opinions of Pediatricians Regarding Mandatory Blood Lead Screening for Children in the Quinnipiack Valley Health District written by Dinny Mathew and published by . This book was released on 2013 with total page 122 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study examined the level of compliance among physicians and their views on the importance of and barriers to routine screening in light of mandatory lead poisoning screening of children six years old and younger in Connecticut since 2009.

Download or read book Screening for Elevated Blood Lead Levels in Children written by Amy Cantor and published by . This book was released on 2019 with total page 76 pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND: In 2006, the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to recommend for or against routine screening for elevated blood lead levels in asymptomatic children ages 1 to 5 years who are at increased risk for lead poisoning (I recommendation), and recommended against routine screening in those at average risk (D recommendation). PURPOSE: To synthesize evidence on the effects of screening, testing, and treatment for elevated blood lead levels in children age 5 years and younger in the primary care setting, to update a prior USPSTF review on screening for elevated blood lead levels in childhood. DATA SOURCES: Cochrane CENTRAL and Cochrane Database of Systematic Reviews (through June 2018), and Ovid MEDLINE (1946 to June 2018), reference lists, and surveillance through December 5, 2018. STUDY SELECTION: English-language trials and observational studies of screening effectiveness, test accuracy, and benefits and harms of screening and interventions in asymptomatic children age 5 years and younger. DATA EXTRACTION: One investigator abstracted details about study design, patient population, setting, screening method, followup, and results. Two investigators independently applied prespecified criteria to rate study quality using methods developed by the USPSTF. Discrepancies were resolved through consensus. DATA SYNTHESIS (RESULTS): A total of 22 studies were included in this review (N=10,449). No studies directly evaluated clinical benefits or harms of screening versus not screening children for elevated blood lead levels. More than one positive answer on the five-item 1991 Centers for Disease Control and Prevention screening questionnaire was associated with a pooled sensitivity of 48 percent (95% confidence interval [CI], 31.4% to 65.6%) and specificity of 58 percent (95% CI, 39.9% to 74.0%) for identifying children with a venous blood level greater than 10 μg/dL (5 studies; N=2,265). Adapted versions of the questionnaire did not demonstrate improved accuracy. Capillary blood lead testing demonstrated sensitivity of 87 to 91 percent and specificity greater than 90 percent, compared with venous measurement (4 studies; N=1,431). Counseling and nutritional interventions or residential lead hazard control techniques did not reduce blood lead concentrations in asymptomatic children, but studies were few and had methodological limitations (7 studies; N=1,419). A trial of dimercaptosuccinic acid chelation therapy found reduced blood lead levels in children at 1 week to 1 year but not at 4.5 to 6 years (N=780), while another trial found no effect at 1 and 6 months (N=39). Seven-year followup assessments showed no effect on neuropsychological development; a small deficit in linear growth (height difference at 7 years in treated patients, 1.17 cm [95% CI, 0.41 to 1.93 cm]) and poorer cognitive outcomes reported as the Attention and Executive Functions subscore of the Developmental Neuropsychological Assessment (unadjusted difference, −1.8 [95% CI, −4.5 to 1.0]; adjusted P=0.045) in children treated with dimercaptosuccinic acid chelation. LIMITATIONS: Limited to English-language articles; quality and applicability of studies were limited due to study design, poor reporting of statistical outcomes, and loss to followup. Studies were lacking on the effectiveness of screening or treatments in reducing elevated blood lead levels or improving health outcomes in children. There was no direct evidence on the harms of screening children for elevated blood lead levels. CONCLUSIONS: Evidence on the benefits and harms of screening children for elevated blood lead levels is lacking. Screening questionnaires are not accurate for identifying children with elevated blood lead levels. Capillary blood testing is slightly less accurate than venous blood testing for identification of elevated blood lead levels. Treatment studies of chelating agents, often combined with environmental or household interventions, were not associated with sustained effects on blood lead levels but were associated with harms.

Download or read book Lead Screening Practices of Pediatricians and Family Practice Physicians in the Rappahannock Area Health District written by Jeanette R. Currence and published by . This book was released on 2001 with total page 26 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Lengthening Shadows written by Council on Pediatric Practice (U.S.) and published by . This book was released on 1971 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Building a Better Tomorrow written by and published by . This book was released on 2000 with total page 558 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Morbidity and Mortality Weekly Report written by and published by . This book was released on 2009 with total page 730 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Rudolph s Pediatrics 22nd Edition written by Abraham M. Rudolph and published by McGraw Hill Professional. This book was released on 2011-04-08 with total page 2546 pages. Available in PDF, EPUB and Kindle. Book excerpt: Accompanying DVD includes the book text and tables, plus supplemental images and chapter bibliographical references. Adobe Air required for viewing; files in PDF or .jpg formats. Auto-installs.

Download or read book Developmental and Behavioral Pediatrics written by Robert G. Voigt and published by . This book was released on 2011 with total page 590 pages. Available in PDF, EPUB and Kindle. Book excerpt: All-new clinical resource for managing children with developmental and behavioral concerns. Developed by leading experts in developmental and behavioral pediatrics, the all-new AAP Developmental and Behavioral Pediatrics gives one place to turn for expert recommendations to deliver, coordinate, and/or monitor quality developmental/behavioral care within the medical home. The one resource with all the essentials for pediatric primary care providers. Evaluation and care initiation: Interviewing and counseling, Surveillance and screening, Psychoeducational testing, Neurodevelopment.

Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.

Download or read book Medicaid written by United States. General Accounting Office and published by . This book was released on 2001 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: