Challenges in monitoring the development of young children in remote Aboriginal health services

Clinical audit findings and recommendations for improving practice

A. D'Aprano, S. Silburn, V. Johnston, R. Bailie, F. Mensah, F. Oberklaid, G. Robinson

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Abstract

Introduction: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services.

Methods: A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011.

Results: A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79%) medical records had some evidence of a developmental check and in Community B there were 42 (59%) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16%) records documented parent report and 20 (20%) documented staffobservations, while in Community B, the numbers were 2 (3%) and 11 (19%), respectively. The overall recorded prevalence of developmental difficulties was 21% in Community A and 6% in Community B.

Conclusions: This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure.

Original languageEnglish
Article number3852
Number of pages10
JournalRural and Remote Health
Volume16
Issue number3
Publication statusPublished - 2016

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Clinical Audit
Child Development
audit
Health Services
health service
monitoring
community
Medical Records
Primary Health Care
Medical Audit
Northern Territory
Health
health
evidence
recording
indication
parents
nurse
Public Health
public health

Cite this

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title = "Challenges in monitoring the development of young children in remote Aboriginal health services: Clinical audit findings and recommendations for improving practice",
abstract = "Introduction: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. Methods: A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011. Results: A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79{\%}) medical records had some evidence of a developmental check and in Community B there were 42 (59{\%}) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16{\%}) records documented parent report and 20 (20{\%}) documented staffobservations, while in Community B, the numbers were 2 (3{\%}) and 11 (19{\%}), respectively. The overall recorded prevalence of developmental difficulties was 21{\%} in Community A and 6{\%} in Community B. Conclusions: This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure.",
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Challenges in monitoring the development of young children in remote Aboriginal health services : Clinical audit findings and recommendations for improving practice. / D'Aprano, A.; Silburn, S.; Johnston, V.; Bailie, R.; Mensah, F.; Oberklaid, F.; Robinson, G.

In: Rural and Remote Health, Vol. 16, No. 3, 3852, 2016.

Research output: Contribution to journalArticleResearchpeer-review

TY - JOUR

T1 - Challenges in monitoring the development of young children in remote Aboriginal health services

T2 - Clinical audit findings and recommendations for improving practice

AU - D'Aprano, A.

AU - Silburn, S.

AU - Johnston, V.

AU - Bailie, R.

AU - Mensah, F.

AU - Oberklaid, F.

AU - Robinson, G.

PY - 2016

Y1 - 2016

N2 - Introduction: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. Methods: A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011. Results: A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79%) medical records had some evidence of a developmental check and in Community B there were 42 (59%) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16%) records documented parent report and 20 (20%) documented staffobservations, while in Community B, the numbers were 2 (3%) and 11 (19%), respectively. The overall recorded prevalence of developmental difficulties was 21% in Community A and 6% in Community B. Conclusions: This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure.

AB - Introduction: Early detection of developmental difficulties is universally considered a necessary public health measure, with routine developmental monitoring an important function of primary healthcare services. This study aimed to describe the developmental monitoring practice in two remote Australian Aboriginal primary healthcare services and to identify gaps in the delivery of developmental monitoring services. Methods: A cross-sectional baseline medical record audit of all resident children aged less than 5 years in two remote Aboriginal health centres in the Northern Territory (NT) in Australia was undertaken between December 2010 and November 2011. Results: A total of 151 medical records were audited, 80 in Community A and 71 in Community B. Developmental checks were more likely among children who attended services more regularly. In Community A, 63 (79%) medical records had some evidence of a developmental check and in Community B there were 42 (59%) medical records with such evidence. However, there was little indication of how assessments were undertaken: only one record noted the use of a formal developmental screening measure. In Community A, 16 (16%) records documented parent report and 20 (20%) documented staffobservations, while in Community B, the numbers were 2 (3%) and 11 (19%), respectively. The overall recorded prevalence of developmental difficulties was 21% in Community A and 6% in Community B. Conclusions: This is the first study to describe the quality of developmental monitoring practice in remote Australian Aboriginal health services. The audit findings suggest the need for a systems-wide approach to the delivery and recording of developmental monitoring services. This will require routine training of remote Aboriginal health workers and remote area nurses in developmental monitoring practice including the use of a culturally appropriate, structured developmental screening measure.

KW - Australia

KW - Australian Aboriginal

KW - Child development

KW - Child health

KW - Developmental monitoring

KW - Developmental risk

KW - Developmental screening

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M3 - Article

VL - 16

JO - Rural and Remote Health

JF - Rural and Remote Health

SN - 1445-6354

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