An Educational Intervention to Improve Clinician Vitamin D Teaching for Parents of Human Milk-Fed Infants.

Abstract

Objective: To increase the number of episodes of vitamin D teaching in the primary care setting for parents of human milk-fed infants and to explore pediatric clinicians' knowledge of vitamin D supplementation in human milk-fed infants and their perception of project intervention usefulness.

Design: Quality improvement project using a quasi-experimental, pretest-posttest design.

Setting/local problem: Despite recommendations from the American Academy of Pediatrics, vitamin D supplementation adherence rates for human milk-fed infants remain low. Parents report vitamin D supplementation teaching in pediatric primary care to be inadequate.

Participants: Three pediatricians and two pediatric nurse practitioners.

Interventions/measurements: A vitamin D educational session for clinicians and an embedded vitamin D template within the electronic health record were implemented into clinicians' daily documentation workflow. Pre- and postintervention vitamin D adherence and clinician-parent teaching data were extracted via chart review for the first four consecutive well-infant maintenance visits. Survey questionnaires assessed clinicians' knowledge about vitamin D supplementation guidelines and intervention content use.

Results: Descriptive statistics and t tests were used to analyze the data. There was a statistically significant 55% change in clinician-parent vitamin D education after the intervention (p = .05). The postintervention vitamin D adherence monitoring documentation demonstrated an increase that was clinically significant for this practice site. One hundred percent of the clinicians reported that the electronic health record template was useful for monitoring vitamin D adherence, and 80% of clinicians stated they would change their practice based on the intervention.

Conclusion: Clinicians' adoption and use of the electronic health record template represents a positive impact. Clinician education and an embedded electronic health record template were associated with an increase in the number of clinician-parent teaching episodes regarding vitamin D supplementation in an infant's first 2 months of life and were associated with clinician behavior change surrounding adherence monitoring.