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School of Nursing

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Browsing School of Nursing by Author "Ajayi, Taiye"

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    Improving Metabolic Screening in Pediatric Patients on Antipsychotics
    Ajayi, Taiye; Lee, Amy; Finn, Edgar
    Introduction: Psychiatric pediatric patients treated with second generation antipsychotic medications are at an elevated risk for developing metabolic syndrome (MS), dyslipidemia and rapid weight gain. Childhood obesity and MS are major issues in the prescribing of second-generation antipsychotics (SGA) due to significant weight gain which carry health consequences both in childhood and into adulthood. Early intervention leads to improved outcomes. This project's overall goal was to increase the metabolic screening rates among pediatric populations prescribed antipsychotics. Methods: In this quality improvement project, metabolic monitoring and screening tool in paper format was provided to all mental health providers at a mental health Federal Qualified Health Center (FQHC) clinic during patients’ medication management visits over a six-week period. The Primary Investigator (PI) conducted a retrospective chart review, using pre and post intervention data in determining compliance with the recommended clinical guidelines for monitoring and screening for metabolic risk factors in patients receiving antipsychotic medications. Results: Metabolic screening rate was calculated using the number of patients that were screened post intervention of the screening tool. The pre-intervention rates and post-intervention rates were compared through a Chi Square analysis. Pediatric patients between the ages of 4-18 that were prescribed antipsychotic drugs were included in the project. MS screening rates did increase significantly post implementation of the intervention, x2(1, N=87) = 13.3481, p =.000259, and the rate of metabolic monitoring increased from 29% to 69% for the primary outcome measures (weight, height, BMI, blood pressure, HbA1C and lipid panel). Discussion: Failure to screen patients prior to initiating antipsychotic drugs and during antipsychotic treatment can lead to omission of key components in screening and monitoring for MS among psychiatric ill patients. This omission leads to a lack of early identification of those at high risk for MS. The project showed clinical and statistical significance, in pediatric patients prescribed antipsychotic medications. Provider education and implementation of a screening tool demonstrated an effective strategy in improving the screening rates of these patients in the pediatric practice. Timely identification and screening for MS is key to preventing cardiovascular morbidity and mortality among patients with severe psychiatric illnesses.