Age
|
Review and screening procedures
|
Immunisation
|
Health promotion
|
Newborn |
Review:
| BCG (high risk) | Cot death prevention |
Family history | Hep B (if mother is a carrier) | Feeding technique |
Pregnancy | Nutrition |
Birth | Baby care |
| Crying |
Full physical examination including:
| Sleep |
Weight | Car safety |
Heart and pulses | Family planning |
Hips | Passive smoking |
Birth marks | Dangers of shaking baby |
Testes | Sibling management |
Head circumference plotted |
Eyes (exclude cataracts and squint) |
Guthrie test after 6 days (PKU, hypothyroidism) |
Sickle cell (if indicated) |
|
Consider: |
Risk factors for hearing loss |
Refer to Can your baby hear you in PHCHR |
|
If high risk then refer for otoacoustic emission, brainstem auditory evoked response |
| | | |
10–14 days | Guided by results and review of neonatal check | Review BCG and Hep B status | Nutrition |
Breast feeding |
Assess and establish levels of support and assistance required | Introduce to immunisation programme and obtain informed consent | Passive smoking |
Accident prevention: bathing, scalding and fires |
Review sickle cell and thalassaemia test (if appropriate) | Explanation of tests and results |
Encouraging parents to request results of all tests |
Significance of prolonged jaundice |
Depression, coping and help (parents/carers) |
| | | |
6–8 weeks |
Review:
| 1st DT Pert Hib/Pol | Immunisation |
Parental concerns, e.g. vision, hearing, activity | Meningococcal C | Nutrition and dangers of early weaning |
Risk factors including significant family history | | Accidents: fires, falls, overheating, scalds |
| | Refer parent toCan your baby hear you? in PHCHR |
Full examination including:
| | Recognition of illness in babies and what to do |
Weight | | Fever management |
Head circumference | | Crying |
Length | | Sleeping position |
Centile plotting | | Passive smoking |
Hip check | | Review of car safety |
Testes | | Depression (parents/carers) |
Eyes: red reflex, squint, movement, tone and general development | |
Heart and pulses | |
Report Guthrie results back to parents | |
| | | |
2–4 months | Parental concerns | 2nd and 3rd DT Pert Hib/Pol | Weighing as appropriate |
| Meningococcal C | Maintain previous health promotion |
| Promotion of language and social development |
| Refer parent to Can your baby hear you? in PHCHR |
| Deter future use of baby walkers |
| | | |
6–9 months | Hip check | | Parental concerns |
Distraction hearing test (catch up for missed neonatal screen, infants moving in) | Nutrition |
Discussion of developmental progress, asking specifically about vision, hearing and language development | Refer parent to Can your baby hear you? in PHCHR |
Check weight and head circumference as required or if parental concern | Accident prevention: fires, choking, scalding, burns, gate guard etc |
Observe behaviour and look for squints | Review of transport in cars |
Dental care |
Play and development needs |
| | | |
13 months | | MMR | |
| | | |
18–24 months | Parental concerns, behaviour, vision and hearing | Review immunisation status |
Safety: |
Observe gait | Accident prevention: falls from heights, drowning, poisoning, road safety |
Emphasise value of comprehension and social communication in relation to speech development (speech and language screening tests) |
Development:
|
Language and play |
Management and behavioural issues |
Measure height and plot | Promote positive parenting |
Toilet training |
Diet, nutrition, prevention of iron deficiency |
| | | |
39–42 months | Enquiry and discussion of vision, squint, hearing, behaviour, language acquisition, development—referral as necessary | Check immunisation status |
Safety: |
Education needs and choices | DT/polio (preschool booster) | Accident prevention: burns, road safety, drowning, poisoning, falls from heights |
Notification of any special educational needs and choices |
Measure height and plot | 2nd MMR |
Development: |
Check testicular descent has been recorded, if not examine | Language and play socialisation |
Where concerns re: hearing impairment, perform test (e.g. McCormick toy discrimination test) | Management of behaviour issues |
School readiness |
Nutrition/diet |
Dental care |
Toilet training |
| | | |
5 years school entrant | Review preschool record including a check for record of testicular and heart examination | Review of immunisation status | Obtain consent for planned programme and health checks |
School entrant review—parent and school nurse | Access to school health |
Establish teachers/parental concerns | School health surveillance programme |
Height (plot and compare with previous measurements), weight and hearing sweep | Sleep |
Friendships/settling at school |
Visual acuity (Snellen) | Accident prevention, road safety, stranger danger |
Observation of gait and fine motor skills | Dentist, dietician |
Management of medicines at school |
Care in the sun |
| | | |
Year 3 | Teacher concerns | | Accident prevention, road safety, safety at play, stranger danger |
7–8 years | Review of records |
Height, weight, vision | Friendships |
General health check | Exercise, nutrition and dental care |
Issues raised by child | Care in the sun |
| | | |
Year 7 | Visual acuity | | Accident prevention |
11–12 years | Colour vision | Relationships |
General health check | Exercise/nutrition |
Issues raised by young person | Smoking |
Support for individual programmes of care | Dental care |
| Management of medication in school |
| Puberty/sexual health |
Care in the sun |
| | | |
Year 8 | | Heaf Test | |
12–13 years | BCG |
| | | |
Year 10 | General health check including height, weight, vision where concerns | Td/polio booster | Substance abuse—alcohol, smoking, drugs, solvents |
14–15 years | Diet/exercise |
Issues raised by young person | Testicular self examination, promotion of cervical cytology |
|
| Sexual health |
Promotion of general practitioner well woman/man check |
Information about health services, e.g. |
Teenage clinics |
Health shop |
Dental health |
Careers |
Stress management |
| | | |
Year 11 | Self referral—issues raised by students | Information to school leavers on need for immunisations as adult catch up immunisation | Self referral—issues raised by students |
15–16 years |
|