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ORCID
0009-0005-7920-6072
Date of Graduation
12-13-2025
Semester of Graduation
Fall
Degree Name
Doctor of Nursing Practice (DNP)
Department
School of Nursing
First Advisor
Erica Lewis
Abstract
Abstract
Background: Sickle cell disease affects approximately 100,000 people in the United States. Advances in medical management and disease-modifying therapies have led to increased life expectancy for patients with sickle cell disease. This has highlighted the need for greater focus on the critical transition from pediatric to adult health care management for patients with sickle cell disease. Methods: Utilizing Collins’ adaptation of Bardach’s eight-fold path for policy analysis, three policy options were compared. The first was a standardized transition policy for outpatient and inpatient pediatrics and an outpatient-only protocol for adults, the second was a standardized inpatient and outpatient one focused on patients as they exit pediatric care only, and the third was a comprehensive, standardized inpatient and outpatient transition policy. These were evaluated using four of the five criteria that Rodriguez-Garcia proposed, as described by Collins. Results: A literature review was conducted as part of the evidence collection, followed by data collection. Qualitative data collection was conducted through stakeholder interviews, separated into internal and external institutions, and then organized by theme. Quantitative data collection was conducted through an electronic medical record review, which included data from patients aged 18-21 at the time of transition between 2021 and 2024. The analysis indicated that maintaining the status quo policy would not address the gap identified by the lack of a standardized inpatient policy but would continue a robust outpatient framework. The other two policies, if implemented, would establish a solid foundation for standardized education, address metrics that limit continuity of care, and establish management in the adult setting. Discussion: After analyzing and comparing outcomes, the best policy for implementation at the focus institution would be a mix of the three policy options reviewed.
