The impact of the "Put Prevention into Practice" initiative on pediatric nurse practitioner practices

Pediatric nurse practitioners (PNPs) are committed to health promotion and disease prevention, especially for children and adolescents. In this project the "Put Prevention into Practice" materials, developed by the Office of Disease Prevention and Health Promotion of the United States Public Health Service, were disseminated to members of the National Association of Pediatric Nurse Associates and Practitioners and evaluated for their impact on child health outcomes.

The evaluation was conducted by chart review of patients seeing PNPs during the first year of national implementation of the project. Data were collected on a form designed for the study at the time of introduction of the materials into the PNPs' practice and 6 months later. Numbers of visits for health maintenance, illness, and emergency department use were compared before and after introduction of materials. Whether the parent brought the Child Health Guide to the visit was also compared before and after materials were introduced. In addition, immunization status, recording of height, weight, developmental screening, and hearing and vision screening were compared before and after introduction of materials. To obtain information about the materials and their applicability to patients, focus groups were used to elicit information from PNPs at two national meetings.

Usable data were received from 14 PNPs representing 194 patients. The results indicated that use of the "Put Prevention into Practice" program increased immunization rates, health maintenance visits, documentation of developmental, hearing and vision screening, and car seat use. No change was seen in documentation of height, weight, and emergency department and illness visits. Members found that the materials were difficult to implement in some populations. Despite the small numbers of participants, these data suggest that use of the "Put Prevention into Practice" materials can improve consistency of preventive care for young children.