Implementing Clinical Practice Guidelines in Family Practice: Caring for Children with ADHD
Abstract
The purpose of this Practice Improvement Project was to promote evidence-based
practice in caring for children ages 4-18 with Attention Deficit Hyperactivity Disorder (ADHD)
in the family practice setting. The American Academy of Pediatric Clinical Practice Guidelines
(CPG) and the Diagnostic and Statistical Manual of Mental Health Conditions, 5th Ed. (DSM-V)
diagnostic criteria for ADHD were embedded in the electronic health record (EHR) in the form
of an evaluation tool/template to guide the Primary Care Providers (PCPs) in documenting
evidence-based practice in the assessment, diagnosis and treatment of ADHD. Primary
stakeholders are PCPs of Riverview Clinic who care for children with ADHD. Neuman’s System Theoretical framework was used assuring a comprehensive holistic
approach to caring for children with ADHD. The logic model was applied to direct project
process while providing a framework for project evaluation. A focused forum was held to
educate PCPs on the American Academy of Pediatrics (AAP) CPG and the DSM-V ADHD
diagnostic criteria. PCPs were introduced to the tool with instruction on use. Six weeks post
launching, a retrospective chart audit was done to evaluate for the presence of evidence basedpractice
documentation with the evaluation tool/template versus without. When utilized, the evaluation tool/template demonstrates a higher rate of documentation
supportive of evidence-based practice. The tool enhances provider’s comfort level in caring for
children with ADHD while promoting optimal quality outcome for the child. Project outcome
suggests the tool be used by PCPs in documenting evidence-based practice. Key words: ADHD,
children, management, EHR, template, co-morbid conditions, and clinical practice guidelines.