Date of Conferral

2018

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Patricia Schweickert

Abstract

A 2009-2010 National Assessment Survey of youth with special needs such as hemophilia showed that 40% of youth between the ages of 12 and 17 had a transition plan before transitioning to adult care services. The lack of a transition plan caused youth to fall into a fragmented care gap when transition services are inadequate. During the gap, youth with hemophilia increased use of the emergency room and were hospitalized for complications such as frequent joint or muscle bleeding and joint disability. As a result, the health status of affected youth becomes fragile and health care costs escalate. The practice problem for this DNP project was the need for transition education and planning for youth with hemophilia. The practice-focused question asked whether a transition quick guide for youth (aged 12-17) with hemophilia enabled them to increase their knowledge of self-care management skills as evidenced by increased post-test scores of transition readiness. The purpose of the project was to prepare youth with hemophilia who are 12 to 17 years old to make a smooth transition from pediatric to the adult hemophilia clinic by using a transition quick guide to educate them about hemophilia and self-care management. The model used to inform this project was the plan-do-study-act (PDSA), a quality improvement method used to test a relatively small change of transition services within the hemophilia clinic. Sources of evidence were taken from 10 participants with hemophilia. Data to assess the project outcome was collected from pre and post educational interventions, along with demographic data to characterize the sample population from participants' clinic records. A descriptive statistics approach to obtain percentage differences between pretest and post test outcome data was used to answer the project question. Pretest data scores on a 10-point scale were between 19% (lowest score for pretest), and 58% (highest score for pretest). Post test scores after educational session were between 42% (lowest score for post test scores), and 95% (highest post test score). The percentage differences between pretest and post test showed a 14% increase in knowledge, showing that knowledge increased using the transition quick guide. The implication for positive social change was that youth who are adequately prepared for the transition to adult care services will avoid unnecessary health complications and enjoy an improved quality of life.

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