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Clinical Pediatrics
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EPSDT Preventive Services in a Low-Income Pediatric Population: Impact of a Nursing Protocol

Pamela C. Hull, PhD

Center for Health Research, Tennessee State University, pamhull{at}tnstate.edu

Baqar A. Husaini, PhD

Center for Health Research, Tennessee State University

Susanne Tropez-Sims, MD, MPH

Departments of Pediatrics

Michelle Reece, MS

Center for Health Research, Tennessee State University

Janice Emerson, MS

Center for Health Research, Tennessee State University

Robert Levine, MD

Department of Family & Community Medicine, Meharry Medical College, Nashville, Tennessee

Medicaid mandates coverage of clinical preventive services for children under the Early and Periodic Screening, Diagnosis, and Treatment program (EPSDT). This article assesses the usefulness of a nursing protocol for delivering comprehensive EPSDT services to pediatric patients during any primary care visit. Secondary data from a recent controlled trial were analyzed. An intervention group received the clinical protocol (n = 514 children in a low-income pediatric clinic), whereas data from a "usual care" comparison group were obtained from medical records (n = 115 children). The nursing protocol included 52 items corresponding to EPSDT services and was administered by a prevention nurse. In the intervention group, 11 605 out of 11 607 (approximately 100.0%) EPSDT service needs were initiated, as compared to 21.2% (572 out of 2695) in the comparison group (P < .001). The study demonstrates the feasibility of using a nursing protocol to integrate EPSDT clinical preventive services into pediatric visits.

Key Words: EPSDT program • nursing protocol • Medicaid

This version was published on March 1, 2008

Clinical Pediatrics, Vol. 47, No. 2, 137-142 (2008)
DOI: 10.1177/0009922807306167
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