Fostering Pediatric Resilience in Outpatient Primary Care: An Evidence-Based Practice Improvement Project

Introduction: Resilience is not a singular trait. Techniques can be learned and/or promoted to increase one’s capacity for resilience. These skills can attenuate both short- and long-term detrimental impacts to a child’s stability, development, and health outcomes. For best outcomes, resilience should be promoted throughout all stages of neuropsychological and physical development. Methods: An educational intervention on resilience techniques was provided to advanced practice registered nurses (APRNs). Pre- and post-intervention APRN knowledge data was collected. The APRNs then integrated resilience techniques into clinical practice during a school semester. Immediately after an APRN implemented resilience techniques into a patient encounter, the child’s caregiver was provided an anonymous five-item questionnaire. After the school semester, the APRNs completed a follow-up questionnaire. Result: Baseline knowledge, post-education knowledge, and post-integration data of APRNs showed increased averages related to comfort discussing resilience promotion techniques, comfort modeling/demonstrating resilience promotion techniques, and perceived feasibility of integration of resilience promotion techniques during patient encounters and in a timely manner. Review of the electronic health record showed documentation of resilience technique integration during two mental health appointments, four mental health medication visits, and 14 patient physicals. Caregiver questionnaires showed that, on average, resilience techniques were believed to be helpful and that the techniques learned were anticipated to be used after the patient encounter to help children handle strong emotions and/or difficult situations. Conclusion: Healthcare providers are in an ideal position to address, educate, and provide anticipatory guidance on age-appropriate, evidence-based resilience promoting techniques.