There is a substantial body of research evidence that associated adverse childhood experiences (ACE’s) to the development of several chronic illnesses in adulthood. Despite the overwhelming evidence that adverse childhood experiences result in chronic diseases; like heart disease, diabetes, and chronic obstructive pulmonary disease, there has been limited application of ACE screenings during routine physical examinations. The purpose of this study is to examine nurse practitioners knowledge and possible perceived barriers to implementing ACE screenings during college entry physical exams.
Methods:
A cross sectional observational study using a web-based survey was used to assess nurse practitioner knowledge of and possible barriers to implementing an ACE assessment during college entry physicals in their practice. The survey was limited to nurse practitioners licensed in the state of Florida. The Florida Association of Nurse Practitioners (FLANP) agreed to forward to FLANP membership the online survey in March of 2018. Spearman rho and Pearson Correlation were the methods selected for statistical analysis using SPSS software.
Results:
A total of 46 nurse practitioners completed the 26 question on-line survey. The surveys findings suggested two possible knowledge deficits. The first was nurse practitioners lack of knowledge of physiological brain changes that occur with adverse childhood experiences, which was correlated to nurse practitioners with less nursing education. The second knowledge deficit was nurse practitioners understanding that adverse childhood experiences lessen the patient’s ability to cope with the stress of college, which was correlated to nurse practitioners with less nursing education. The possible barriers to ACE implementation were related to a perceived barrier of not having enough time to do the ACE assessment, which was correlated to nurse practitioners who had less nursing education and also who had an NP license for a shorter period of time.
Conclusion:
Nursing educators need to evaluate curriculum at the bachelorette and masters’ level to improve nursing knowledge about ACE’s and nurse practitioners should address possible pathways in the implementation of ACE assessments in their clinical practice to improve workflow and improve time constraints in practice. Nurse practitioners should consider implementation of ACE’s during routine physical exams as a possible solution.