Date of Award

Spring 5-25-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Sharon Boothe-Kepple, PhD, MSN, FNP-C, PHN (Chickasaw)


Approximately 13% of the pediatric population suffer from atopic dermatitis (AD) or eczema (Silverberg & Simpson, 2014). Eczema is a complex and costly managed disease. There is a need to improve caregiver knowledge and to maintain and control exacerbations as national prevalence increases in the United States. Literature supports utilization of a written Eczema Action Plan (EAP) to improve caregiver self-efficacy of eczema management. An evidence-based practice project was conducted in a primary care pediatric practice implementing a written EAP for mild to severely diagnosed patients ranging from 4 months to 17 years of age. The practice intervention included providing each caregiver with an individualized written EAP developed by the American Academy of Dermatology (AAD), an eczema patient education handout by The Society for Pediatric Dermatology, and a list of over-the-counter products endorsed by the National Eczema Association. Thirty caregivers were recruited for this pilot and 22 participants completed the project. The validated Patient Oriented Eczema Measurement for children (POEM) and the Parental Self-Efficacy Care Index (PASECI) tools were completed by caregivers pre-intervention and again between 6- and 8-weeks post-intervention. Eczema severity decreased by approximately 65% and caregiver self-efficacy increased with an average score of 8.11/10 utilizing the PASECI. A written EAP is easily adaptable in the primary care setting closing communication barriers between caregiver and provider. Utilization of a written EAP establishes best care practice congruent with the American Academy of Pediatrics (AAP) clinical guidelines. Potential benefits include reduction in follow-up visits, treatment costs, improvement in referral identification, and increased caregiver and patient satisfaction.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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Nursing Commons