Background: Pediatric obesity and cardiovascular diseases are conditions which continue to increase globally. The continued increase of both disease states extends beyond pediatric years adding health risks into adulthood. Both conditions can be positively impacted by lifestyle and behavior modifications gained through effective patient education. Foreground: Nationally the childhood obesity rate continues to climb. Healthy People 2020 includes obesity and cardiovascular disease as health initiatives in the pediatric population. The pediatric population residing in some Southeastern states have a rate of obesity greater than 20% exceeding rates of other regions. A meeting with a local medical director of a pediatric wellness center revealed a desire to improve the practice approach to include health initiatives consistent with Healthy People 2020. The principle investigator and practice founder agreed upon an endeavor to incorporate the American Academy of Pediatrics (AAP) “Expert Panel of Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents” (CVH) as the accepted method to direct patient treatment and care. Methods: A multidisciplinary treatment team implemented the CVH guidelines with each patient visit and an electronic health record (EHR) flagged elevated blood pressure readings at the wellness center. Wellness center patient’s charts randomly audited by the principle investigator (PI) showed the CVH guidelines and system flags. PI checklists evaluated indices in care and elevated blood pressure readings. Larrabee’s Quality Nursing Care Theory was the theoretical framework: The model guided thorough implementation of the practice change. Implementation steps are: Assess need for practice change; Locate best evidence; Integrate and maintain change in practice; critically analyze evidence; implement and evaluate change in practice; and design practice change. Findings/Results: Implementing CVH proved instrumental in providing constancy of an evidence-based approach in care of hypertension and provided an opportunity to educate providers and to ensure future congruency in care. They realized the need and opportunity to target the pediatric obesity epidemic within wellness center. Conclusions/Recommendations: An upgraded EHR would lower the burden of time necessary to overcome numerous barriers and restrictions. A larger patient population would assist in complete and successful implementation and assesssment of the change.
