Authors' Affiliations

Doctor of Nursing Practice program, College of Nursing East Tennessee State University, Johnson City, TN.

Location

Culp Ballroom

Start Date

4-7-2022 9:00 AM

End Date

4-7-2022 12:00 PM

Poster Number

52

Faculty Sponsor’s Department

Nursing

Name of Project's Faculty Sponsor

Beth Schreiner

Classification of First Author

Graduate Student-Doctoral

Competition Type

Competitive

Type

Poster Presentation

Project's Category

Healthcare and Medicine, Ambulatory Care, Family Health Services, Health Care Cost Containment, Health Care Management, Health Information Technology, Health Maintenance Organizations, Health of Underserved Populations, Health Services Delivery, Patient Care and Education, Patient Care Planning, Public Health, Quality of Life, Safety

Abstract or Artist's Statement

Adverse Childhood Experiences (ACEs) include childhood exposure to abuse or violence, a parents' divorce, mental illness, substance use disorder, and are identified as risk factors for negative life outcomes. While ACEs screenings are commonly used in mental health and pediatric settings, screening for ACEs in primary care settings is less prevalent. The purpose of this project is to integrate screening for ACEs into a primary care setting and make appropriate referrals for follow-up, thus reducing potential negative life outcomes. The process was designed for a primary care practice located in Winston-Salem, North Carolina. Part one assessed level of awareness and screening history which determined training focus. Each provider and staff member received 30-45 minutes of training on ACEs screening algorithm, a detailed approach to guide treatment. The training was followed by question-and-answer sessions to address concerns. Part two, involved screening using the Center for Youth Wellness, Adverse Childhood Experiences Questionnaire for Children (CYW ACE-Q Child) which was initiated by the front office employee. Front office employee identified patients present for an annual well visit, briefly explained the screening tool, and handed it to the patient on a clipboard. The patient returned the completed form to the Certified Medical Assistant (CMA) when called in from the waiting room. The provider reviewed the ACEs screening and made referrals as appropriate. Part three involved data collection and analysis. Responses were collected weekly for nine weeks. The responses collected will be analyzed using quantitative statistics. The expected outcome is to note progressive increase in screening activities and when appropriate, followed by referrals to community agencies and organizations. The project educated clinicians about ACEs and created awareness among clinicians in a primary care setting to mitigate potential negative life outcomes. Barriers to integrating ACEs screening included employees' absence of training, lack of confidence in the subject matter, limited time frame to complete the screening, and fear of damaging patient-provider relationships. Barriers were mitigated through employee training, repetitive implementation of ACEs screening, and therapeutic communication with patients. The CYW ACE-Q was reserved for those arriving early or on time for their annual wellness visit to allow adequate time for completion. Recommendations include incorporating the CYW ACE-Q into all primary care visits to further intervene with referrals thereby enhancing patients' overall quality of life.

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Apr 7th, 9:00 AM Apr 7th, 12:00 PM

Screening for Adverse Childhood Experiences in Primary Care.

Culp Ballroom

Adverse Childhood Experiences (ACEs) include childhood exposure to abuse or violence, a parents' divorce, mental illness, substance use disorder, and are identified as risk factors for negative life outcomes. While ACEs screenings are commonly used in mental health and pediatric settings, screening for ACEs in primary care settings is less prevalent. The purpose of this project is to integrate screening for ACEs into a primary care setting and make appropriate referrals for follow-up, thus reducing potential negative life outcomes. The process was designed for a primary care practice located in Winston-Salem, North Carolina. Part one assessed level of awareness and screening history which determined training focus. Each provider and staff member received 30-45 minutes of training on ACEs screening algorithm, a detailed approach to guide treatment. The training was followed by question-and-answer sessions to address concerns. Part two, involved screening using the Center for Youth Wellness, Adverse Childhood Experiences Questionnaire for Children (CYW ACE-Q Child) which was initiated by the front office employee. Front office employee identified patients present for an annual well visit, briefly explained the screening tool, and handed it to the patient on a clipboard. The patient returned the completed form to the Certified Medical Assistant (CMA) when called in from the waiting room. The provider reviewed the ACEs screening and made referrals as appropriate. Part three involved data collection and analysis. Responses were collected weekly for nine weeks. The responses collected will be analyzed using quantitative statistics. The expected outcome is to note progressive increase in screening activities and when appropriate, followed by referrals to community agencies and organizations. The project educated clinicians about ACEs and created awareness among clinicians in a primary care setting to mitigate potential negative life outcomes. Barriers to integrating ACEs screening included employees' absence of training, lack of confidence in the subject matter, limited time frame to complete the screening, and fear of damaging patient-provider relationships. Barriers were mitigated through employee training, repetitive implementation of ACEs screening, and therapeutic communication with patients. The CYW ACE-Q was reserved for those arriving early or on time for their annual wellness visit to allow adequate time for completion. Recommendations include incorporating the CYW ACE-Q into all primary care visits to further intervene with referrals thereby enhancing patients' overall quality of life.