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Background: An examination of procedure cancellations found that the lack of preprocedural oral screening was a preventable cause, for children with congenital heart disease. The purpose of this study was to implement an oral screening tool within the pediatric cardiology clinic, with referral to pediatric dental providers for positive screens. The target population were children age ≥ 6 mo. to < 18 yr. old, being referred for cardiac procedures. Methods: The Quality Implementation Framework method was used for this study design. The multimodal intervention included education, audit and feedback, screening guidelines, environmental support, and interdisciplinary collaboration. Baseline rates for oral screenings were determined by retrospective chart audit from January 2018 to January 2019 (n=211). Adherence to the oral screening tool was the outcome measure. Positive oral screens, resulting in referral to the pediatric dental clinic, were measured as a secondary outcome. Provider compliance rates were used as a process measure. Results: Data collected over 14-weeks showed a 29% increase in documentation of oral screenings prior to referral, as compared to the retrospective chart audit. During the study period 13% of completed screenings were positive (n=5). Provider compliance for the period averaged 70%. Conclusion: A substantial increase in preprocedural oral screenings by pediatric cardiologists was achieved using the Quality Implementation Framework, and targeted interventions.

Author Supplied Keywords

Congenital heart diseases, Oral health, Preventative medicine, Practice patterns, physicians, Endocarditis, bacterial


Medical screening; Dental care; Pediatric cardiology; Congenital heart disease in children

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Copyright for this work is retained by the author.

NRS 662 - DNP Scholarly Project III

Document Type

Doctoral Project