Date of Award

Spring 5-24-2019

Document Type

Doctor of Nursing Practice Final Manuscript

Degree Name

Doctor of Nursing Practice



First Advisor

Martha G. Fuller, PhD, PPCNP-BC

Second Advisor

JoAnn Pun, CPNP, Clinical Mentor


Peanut allergies are the leading cause of death from food anaphylaxis. In 2017, the National Association of Allergy and Infectious Disease (NIAID) issued a guideline for use by primary care providers to identify infants who would benefit from early peanut consumption. Many providers have not yet implemented these guidelines in clinical practice. The purpose of this project was to implement a practice change to improve assessment of risk factors for peanut allergies utilizing the NIAID guideline in infants at their six-month well-child examination at a pediatric primary care practice. Risk factors assessed included: a history of eczema and/or egg allergy categorized by eczema and egg allergy severity. Family history, seen as a moderate risk factor for food allergy, was also assessed. The risk assessment was implemented by creating a provider alert on six-month wellness forms and a field for documentation into the electronic health record. Providers were given education materials for families of infants who would benefit from safe, early peanut consumption. This project is important for clinical practice; infants begin consuming solid foods at or around six-months of age and this is a critical time to address risk for future allergies and educate families on benefits of early consumption of allergenic foods, such as peanuts. Primary Care providers in primary care play a pivotal role in addressing new practice change. This project provides a framework for provider identifications of at-risk infants to move toward prevention of lifelong peanut allergy.