Triage in preventive child healthcare: a prospective cohort study of care use and referral rates for children at risk

Bezem, Janine; Kocken, P.L.; Kamphuis, M.; Theunissen, M.H.C.; Buitendijk, S. E.; Numans, Mattijs E.

doi:10.1136/bmjopen-2017-016423

Cited by 4 publications

(3 citation statements)

References 26 publications

(28 reference statements)

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“…In the European Union, children and adolescents' access to primary healthcare services depends on the country. Literature shows that most preventive public healthcare programs for children and young people consist of a general physical and psychosocial examination, systematic screenings in asymptomatic children, immunization and health education (Bezem et al., 2014, 2017; Wieske et al., 2012; Wood et al., 2012), where nurses are part of the primary healthcare teams. The studies performed in Europe (Berlin et al., 2006, 2008; Isma et al., 2012, 2013; Soriano Faura et al., 2016) were conducted in Sweden and one in Spain.…”

Section: Discussionmentioning

confidence: 99%

Paediatric nursing clinical competences in primary healthcare: A systematic review

Jimenez

Poyato

Montañés³

et al. 2021

Journal of Advanced Nursing

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Aims To identify and critically appraise the available evidence on paediatric nurses’ clinical competencies performed autonomously regarding disease prevention and health promotion activities for children and adolescents in primary healthcare worldwide. Design A systematic review design in accordance with the Preferred Reporting Items Systematic Reviews and Meta‐Analyses statement. Data sources The search was conducted through MEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, SCOPUS, The Cochrane Library, Scientific Electronic Library Online, Web of Science and The Joanna Briggs Institute EBP (Ovid) databases. The grey literature was reviewed at OpenGrey. Additional studies were located through a references list of selected studies identified on first search. Review methods Database search employed MeSH terms: (paediatric nursing) AND (primary healthcare) AND ((clinical skills) OR (clinical competences)). Studies published from inception to October 2019 exploring paediatric nurses' clinical competencies in primary healthcare were eligible for inclusion. No language restrictions were applied in the main search. Selection was made by two reviewers independently. Three independent reviewers assessed the methodological quality of included studies. Results Eighteen studies were included from six countries. The most common nursing competencies independently performed identified and described in studies were Health education and advice, Child and adolescent health and development assessment, Immunizations and Child health checks. Conclusion Studies describe clinical competencies of nurses in children care. No consistent scientific evidence is available about clinical competencies of paediatric nurses performed autonomously in primary care. Impact Few scientific studies identifying and assessing nurses' child primary healthcare skills were found and therefore recorded. Studies describe nurses' clinical skills in childhood, but results do not show firm consistency assessing their practice scope. Health policy‐makers should encourage the development of nurses' competencies if they wish to preserve quality and equity of healthcare services to children. Therefore, the first step is to identify the autonomous competencies of paediatric nurses in primary care.

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Section: Discussionmentioning

confidence: 99%

Paediatric nursing clinical competences in primary healthcare: A systematic review

Jimenez

Poyato

Montañés³

et al. 2021

Journal of Advanced Nursing

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“…The contribution of education professionals in accordance with ethical rules could also be more formalized. This needs to be properly assessed, however, and can only work through close collaboration between education professionals and primary care professionals ( 33 , 34 ). A targeted medical examination for children detected by initial screening could be proposed based on “proportionate universalism” ( 35 ).…”

Section: Discussionmentioning

confidence: 99%

Child health screening program in French nursery schools: Results and related socioeconomic factors

et al. 2023

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ObjectivesThe study aims to describe the output of routine health screening performed in French nursery schools by the maternal and child health services among children aged 3–4 years and to quantify the level of early socioeconomic health disparities.MethodsIn 30 participating départements, data on screening for vision and hearing impairments, overweight and thinness, dental health, language, psychomotor development, and immunizations were collected for children born on specific dates in 2011 and enrolled in nursery school in 2014–2016. Information was collected on the children, their socioeconomic characteristics and on the school attended. Odds of abnormal screening results were compared for each socioeconomic factor by logistic regressions adjusted for age, sex, prematurity and bilingualism.ResultsAmong the 9,939 children screened, prevalence of disorders was 12.3% for vision, 10.9% for hearing, 10.4% for overweight, 7.3% for untreated caries, 14.2% for language and 6.6% for psychomotricity. Newly detected visual disorders were more frequent in disadvantaged areas. Children with unemployed parents were three time more likely to have untreated caries and twice as likely to present language or psychomotor impairments; 52% were referred to a health professional following screening compared to 39% of children with employed parents. Except for children in disadvantaged areas, vaccine coverage was lower among disadvantaged groups.ConclusionThe prevalences of impairments, which are higher among disadvantaged children, highlight the potential preventive impact of systematic screening under the comprehensive maternal and child healthcare program. These results are important to quantify early socioeconomic inequalities in a Western country known for its generous social welfare system. A more holistic approach to child health is needed with a coherent system involving families and aligning primary care, local child health professionals, general practitioners, and specialists. Further results are needed to evaluate its impact on later child development and health.

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“…The professional also provides vaccinations, in line with the national protocol [13]. At school age, there is a standardized two-steps screening procedure, with as first step a pre-assessments of all children (including a questionnaire, parent form or > 12 self-report form) carried out by a PCH assistant and as second step only inviting children at risk of health or developmental problems based on findings of the first step (< 12 years with parents) for a physical assessment and/or health interview by a CHP [11,14].…”

Section: Procedures and Measuresmentioning

confidence: 99%

Developmental monitoring: benefits of a preventive health care system

Theunissen¹,

Bezem

Reijneveld

et al. 2022

Eur J Pediatr

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This study aims to assess the identification rates in a developmental monitoring system (i.e., preventive child healthcare, PCH system) regarding identification of emotional, behavioral (EB) problems, cognitive developmental and family problems in children, and the contribution of such a system to referral to (specialized) mental health and social care services. Over a predetermined period of 6 months, we retrieved data from a random sample of 1370 children aged 0 to 18 years from the registries of two PCH organizations in the Netherlands. We assessed the degree to which PCH professionals identify EB and cognitive developmental and family problems and invite children with these problems for follow-up PCH assessments or refer them to (specialized) mental health and social care services. Among preschool-aged children, we identified 22% with EB problems, cognitive developmental and/or family problems (mainly EB and family problems). Among school-aged children, numbers varied from 10 to 14% (mainly EB). PCH invited 3 to 10%, varying in proportions of child age, for a follow-up assessment, and referred 0 to 4% of the children to external services.Conclusion: A developmental monitoring system with only preventive tasks may help to identify children with EB, cognitive developmental, and/or family problems. This can lead to early support for most of these children, with low referral rates to (more specialized) mental health and social care services. Our findings deserve validation in comparable settings and in other countries. What is Known:• Well-child care requires monitoring of the health and development of children for timely identification of problems and subsequent intervention. • The Dutch Preventive Child Healthcare system is an example of a developmental monitoring system with only preventive tasks. What is New:• A developmental monitoring system with only preventive tasks may help to identify children with problems, resulting in early support for the majority. • This may reduce referral rates to (more specialized) mental/social health services.

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Triage in preventive child healthcare: a prospective cohort study of care use and referral rates for children at risk

Cited by 4 publications

References 26 publications

Paediatric nursing clinical competences in primary healthcare: A systematic review

Paediatric nursing clinical competences in primary healthcare: A systematic review

Child health screening program in French nursery schools: Results and related socioeconomic factors

Developmental monitoring: benefits of a preventive health care system

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