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Cent r e f or Communi t y Chi l d Heal t h Scr eeni ng I nf ant s bel ow 36 we e k s Gest at i onal Age in Vi ct or i a 2011-2012 Gabr i el l e Kavanagh Seni or Pr oj ect Of f i cer VI HSP , Zef f i e Poul aki s Mel i nda Bar ker and Ji l l Cl ar ke ,

we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

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Page 1: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eeni ng I nf ant s bel ow 36week s Ges t at i onal Age i n

Vi c t or i a 2011-2012

Gabr i el l e Kav anagh

Seni or Pr oj ec t Of f i c er VI HSP,

Zef f i e Poul ak i s Mel i nda Bar k er and J i l l Cl ar k e,

Page 2: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Vi c t or i an I nf ant Hear i ng

Sc r eeni ng Pr ogr am

Page 3: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Qual i t y Moni t or i ng&

• Lar ge moni t or i ng pr oj ec t s ar e a

par t of our ongoi ng qual i t y pl ans

• Di f f i c ul t t o i nv es t i gat e s pec i f i c s

• Unabl e t o aut omat i c al l y r epor t or

al er t ev ent s l i k e s c r eeni ng bef or e 34.0wk s CGA

Page 4: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

El i g i b l e or not ?

• Ges t at i onal Age :wk s and mont hs>34 <6

• Wel l t er m baby,

• As l eep or i n a

s et t l ed s t at e

• Cl os e t o di s c har geI mr an

Page 5: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Ac t ual GA &VI HSP dat abas e GA f i el d

• Fi r s t poi nt of r oundi ng i s at bi r t h

not i f i c at i on dur i ng dat a ent r y

• 33.4

à wk s33

• 33.5

à wk s34

• Sec ond poi nt of r oundi ng i s a dai l y

adj us t ment by t he VI HSP dat abas e

I NELI GI BLE babi es on= ‘TO DO’ l i s t

Page 6: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eened week s: <34

of babi es s c r eened GA wk s% <34

of al l el i gi bl e bi r t hs not i f i ed t o VI HSP( )

0.08%

Number of babi es s c r eened GA wk s<34

61

Page 7: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eened week s r es ul t s<34 :

Loc at i on

• Al l s c r eened i n SCN or

NI CU

• 67% i n one of t he

or i gi nal t er t i ar y4 NI CUs

• 13 VI HSP s i t es

i nv ol v ed

Sc r een r es ul t s

• 56 pas s ed AABR1

• 5 wer e r es c r eened

• 1 r ef er r ed

• Di agnos i s not

y et det er mi ned

Page 8: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Cor r ec t ed Ges t at i onal Age at t he

t i me of s c r eeni ng i nel i g i b l e

babi es

Gestational Age at the time of screen

Num

ber o

f babie

s

Page 9: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Cor r ec t ed Ges t at i onal Age at t he

t i me of s c r eeni ng i nel i g i b l e

babi es

Gestational Age at the time of screen

Num

ber o

f babie

s

Page 10: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Cor r ec t ed Ges t at i onal Age at t he

t i me of s c r eeni ng i nel i g i b l e

babi es

Gestational Age at the time of screen

Num

ber o

f babie

s

Page 11: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Cor r ec t ed Ges t at i onal Age at t he

t i me of s c r eeni ng i nel i g i b l e

babi es

Gestational Age at the time of screen

Num

ber o

f babie

s

Page 12: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Ar ea Coor di nat or c omment s –“Why do we t hi nk we ar e s c r eeni ng?”• They ar e on t he TO DO

l i s t !

• Di s c har ge nur s es wer en’ts ur e t he baby woul d go t o

anot her hos pi t al or home .

• Ner v ous nes s ar ound

t r ans f er r i ng t o anot her

s i t e

• St af f don’t want t o l os e

s c r eeni ng s k i l l s .

• Di f f er ent s our c e f or GA

i nf or mat i on .

Ley ah

Page 13: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eened : 34 – week s36

Number of babi es

s c r eened GA wk s<36

of al l bi r t hs% (~

s c r eened GA75,000)

wk s<36

2100 2.85%

Number of babi es

GA wk s<36

of al l% bi r t hs (~

GA wk s75,000) <36

5033 6.7%

of% babi es bor n GA wk s who wer e<36 s c r eened GA wk s<36

42.9%

Page 14: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eened 34 – week s Res ul t s36 :

Loc at i on

• babi es i n r egul ar50 pos t nat al war ds

• VI HSP s i t es58% i nv ol v ed

Sc r een r es ul t s

• 1934 pas s ed AABR1

• 166 r es c r eened

• 20 r ef er r ed t o

Audi ol ogy

Page 15: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eened 34 – week s36 :Ref er r al Out c omes

Page 16: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Sc r eener c omment s

– s c r eeni ng Young Babi es

• Sl eepi ng s et t l ed i nt o, f eedi ng

• Qui c k er s c r eens

• Fami l y r eques t

• Di s c har ge pl an wi t h

under l y i ng pr es s ur es on

SCN beds

• I nt ui t i on

• Di s c har ged home v er y y oung

and s omet i mes i n pos t -nat al war ds

Page 17: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Conc l us i ons - Sc r eeni ng Too Young

and Young Babi es

• Dat abas e updat e

• I mpr ov ement i n GA f i el d t o i nc l ude week and day not i f i ed

t o VI HSP

• Shoul d t he dat abas e r ej ec t s c r een f or an i nel i g i bl e

baby?

• Ongoi ng educ at i on of s t af f s t ak ehol der s&

• Enc our age s t af f t o ut i l i s e t he VI HSP ‘t o do ’ l i s t

• Reduc e ‘ur genc y ’ of ear l y s c r eeni ng

• Cont i nue t o enc our age s t af f t o pr ov i de f ami l i es wi t h t he

bes t oppor t uni t i es t o ac c es s a hear i ng s c r een .

• Moni t or i ng

• Cont i nued moni t or i ng of age at t i me of s c r een

Page 18: we eks Ge stat ional Age in Vi ctoria 2011-2012 · Ce ntrefor Co mmu ni tyCh ildHe al th Screened

Cent r e f or Communi t y Chi l d Heal t h

Ley ah

I mr an