Primary Care Resource and Referral Guide for Children 4-11 Years of Age with ADHD
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Abstract
The practice-improvement project (PIP) assessed five family nurse practitioners and one
pediatrician regarding the use and evaluation of a community treatment guideline packet.
Attention deficit hyperactivity disorder (ADHD) is a commonly diagnosed, chronic,
neurobehavioral disorder, and high-quality, evidence-based management is associated with
improved outcomes. Research has shown an increase in the diagnosis rate for ADHD, and the
need for intensified clinical management of children, 4-11 years of age, with ADHD. Without
proper evaluation or management of ADHD symptoms, the child may continue to struggle
throughout life. Family nurse practitioners (FNPs) employed in rural communities may be the
first point of contact for children, 4-11 years of age, who present with ADHD
symptoms. Providers need to be knowledgeable about ADHD, the treatment guidelines,
community resources, and the proper referrals within the community.
The PIP was designed to assist providers in 5 Minnesota communities who see 4-11 yearold
children with ADHD symptoms. The PIP design included the creation and presentation of a
treatment-guideline packet for 5 FNPs and 1 pediatrician in the rural communities. The
providers volunteered to utilize and evaluate the packet for 6 weeks in January and February,
2014. To evaluate the treatment-guideline packet, a post-questionnaire was completed by each
provider who participated.
The practice improvement project results indicated that 100% (n=6) of the providers felt
that the treatment-guideline packet was helpful and would benefit practice. Providers felt the
packet addressed a practice need by containing both a community resource/referral algorithm and
an evidence-based ADHD process-of-care algorithm. Three-fourths of the providers felt that
using the Vanderbilt Assessment Scales for diagnosing children would be a helpful addition to
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the packet to assist with diagnosing ADHD in children of this age group. Overall, providers felt
that being more aware of the potential referrals and resources in the community would allow a
multi-modal approach of care, therefore improving their management of children, ages 4-11,
with ADHD.