STRUCTURE | |
Waiting room/clinic area | |
Suitable temperature of the room (comfortable for child in vest) | |
Adequate seating | |
Generally clean room | |
Someone to welcome parents | |
Toys in waiting area | |
Notice board on child health issues | |
Pram park (lockable) or space for prams in waiting room | |
Appropriate child health records available | |
Full set of standard growth charts available (boys/girls/weight/height/head circumference) | |
Relevant child health leaflets freely available | |
Baby weighing scales (electronic) | |
Scales suitable for weighing a child | |
Provision for private discussion with a parent | |
Provision for breast feeding in private | |
Child toilet seat/potty in toilets | |
Examination room | |
Toys available | |
Suitable temperature for child in vest | |
Measuring mat (standard) | |
Appropriate height measure | |
Tape measure | |
Equipment for developmental assessment, e.g. crayons/paper/cubes | |
Safety | |
Electrical, e.g. plug covers, wires | |
Furniture, e.g. no sharp corners at head height, radiators, stacked chairs | |
Fire exits/stair safety, e.g. open stairs, low windows | |
Toys/play material, e.g. broken toys | |
Clinical equipment, e.g. sharps bins, scissors out of reach of children | |
Other comments | |
Staff should be suitably trained | |
If vaccines kept for immunisations: | |
fridge thermometers (max/min) present | |
fridge temperature checked daily | |
Provision of interpreters where necessary | |
PROCESS | |
When a parent and child attend a baby clinic: | |
They should be made welcome | |
There should be opportunity for the parent to ask questions | |
Weights should be recorded in the appropriate records and explained | |
Time should be spent with the parent, questions answered/explanations/reassurance given | |
Possibility of discussion in a private room should be offered | |
Appropriate follow up arrangements should be made | |
Baby clinics should have: | |
An appointment system allowing parents to attend with and without an appointment | |
A doctor and health visitor available to be seen by parents | |
At each child health surveillance review: | |
Parental concerns should be discussed | |
Physical assessment of the child should be made | |
Assessment of developmental progress should be made | |
Weight and, if appropriate, height and head circumference should be measured accurately and compared with standard centile charts | |
Health education issues should be discussed | |
Immunisations should be reviewed | |
Results should be recorded in the personal child health record | |
Appropriate follow up arrangements should be made | |
There should be a call up system | |
There should be a recall system for non-attenders | |
Other comments | |
There should be liaison between doctors and health visitors | |
Child health surveillance should be seen as a continuous process and not a system of checks at specific ages | |
In this health authority (HA), the programme of child health surveillance reviews that is followed should be consistent with the HA preschool child health surveillance policy and the HA personal child health record | |
OUTCOME | |
Parent satisfaction | |
Parents will feel able to discuss their concerns: | |
with their health visitor | |
with their doctor | |
Parents will feel welcome at the baby clinic | |
Parents should have the results of any assessment explained to them so that they can understand | |
Uptake and timeliness of child health surveillance reviews (preschool targets) | |
All babies should have neonatal examination during first 48 hours of life | |
90% of 10–14 day reviews should done by 4 weeks | |
90% of 6–8 week reviews should be done by 12 weeks | |
90% of 6–9 month reviews should be done by 10 months | |
90% of 18–24 month review should be done by 28 months | |
90% of 3 year reviews should be done by 3 years 9 months | |
Immunisation rates | |
95% of children should be fully immunised by 2 years |
Adapted from Blair ME, Hampshire A, Crown N,et al. An audit of preschool child health surveillance in Nottingham 1993–6. Final report. London: Department of Health, 1997.