TOOLKIT TO IMPROVE PROVIDER ADHERENCE TO METABOLIC MONITORING OF ATYPICAL ANTIPSYCHOTICS FOR YOUTHS Public Deposited

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Last Modified
  • March 21, 2019
Creator
  • Carpenter, Lindsey
    • Affiliation: School of Nursing
Abstract
  • Problem: The use of atypical antipsychotic medications (AAPs) to treat bipolar and other mood disorders has increased in pediatric populations. The potential metabolic side effects of these medications increase the risk of negative health outcomes. Providers are aware of practice guidelines regarding these medications but fail to adhere to them. Practice toolkits are quality-improvement interventions aimed at improving guideline compliance. Purpose: The purpose of this project was to implement a toolkit to increase adherence to guidelines for metabolic measures in patients aged 5-18 with a bipolar disorder taking an atypical antipsychotic. Methods: A toolkit containing necessary order, assessment, and documentation forms was deployed in an outpatient mental health office in North Carolina. Plan-Do-Study-Act cycles were conducted to guide implementation. Providers included a Doctor of Osteopathic Medicine, Psychiatric-Mental Health Nurse Practitioners, and a Physician Assistant. Chart audits were conducted and compliance data was displayed as run charts compared to baseline data. Outcome measures included: completion of metabolic assessment, appropriate laboratory ordering, and completion of vital sign measurements. Results: Outcome measures showed improved adherence rates to monitoring vital signs, ordering appropriate labs, and performing a metabolic assessment. These improvements varied among providers. Implications: While improvements occurred, there were still barriers to implementation such as lack of time. Ongoing assessment of barriers is necessary to sustain the changes and to ensure consistent application of the guideline recommendations by all providers.
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Advisor
  • Hubbard, Grace
  • D'Auria, Jennifer
  • Furr-Trenery, Christie
Degree granting institution
  • University of North Carolina at Chapel Hill
Graduation year
  • 2018
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