Keywords

Commonly allergenic foods, early introduction, food allergy, food introduction, pediatric, provider training, quality improvement

 

Authors

  1. Hodges, Juliana M. DNP, RN, CPNP-PC (Director of Quality)

ABSTRACT

Background: Pediatric food allergies (FAs) present significant health and economic problems. Currently, there are no cures for FAs. Recent studies suggest that early introduction (EI), between 4 and 6 months of age, of commonly allergenic foods (CAFs) may reduce the risk of developing FAs. This contradicts the current standard of care, food avoidance.

 

Local problem: A federally qualified health center saw 894 patients aged 0-24 months during a 12-month period with only 18.9% receiving nutrition education. New dietary recommendations to prevent FA were not in place.

 

Methods: A retrospective chart review was used to evaluate use of an order set with patient education on EI to CAFs in the electronic medical record (EMR).

 

Interventions: Providers attended training on EI to CAFs and use of the EMR order set. Data were collected on the use of the order set over a 3-month period.

 

Results: Provider training significantly improved knowledge of FA as well as EI guidelines. After 3 months of implementation, 25.95% of eligible encounters contained the EI order set; 52% of patients received the order set during the measurement period. In the impact population, patients 4-12 months of age, 74.55% of patients received the order set.

 

Conclusions: Evidence-based clinical content in EMR order sets coupled with provider training ensure clinical decision support in identifying, monitoring, and optimizing quality care standards.