Paediatric Nurse Consultant, Angela Lee was delighted to be named as runner up in the Child Health Award category in the RCNi Nurse Awards; the profession’s top accolade for nursing excellence last Friday, 6 May.
Angela and her colleagues were recognised for their work on the early detection of infant hip dysplasia at a special event, held at the Westminster Park Plaza, London, celebrating nursing excellence in improving the health of children and young people.
“Since the late 1960s infants have been screened for developmental hip dysplasia (DDH), and the importance for early identification of the condition has been well documented. However, in 2008 changes to the national screening programme reduced the surveillance for this condition, leaving only a six-eight week hip check as standard,” explained Angela.
With the removal of the 8 month check, the paediatric team felt the gap in the screening programme could mean that infants with DDH may not be identified until walking age.
Angela added: “We know that early management of DDH is less invasive and can have a better outcome for the child, so we got our heads together to come up with a plan that would help.”
The team agreed that enlisting parents as screeners to aid in the earlier detection of infant hip dysplasia could be a solution. They were aware of what simple signs could help identify hip dysplasia and as a paediatric skilled team also understood the value of parents and their ability to know their own child.
Seeing parents who had babies diagnosed with hip dysplasia they observed that in the vast number of cases where a clinical sign was clearly noted by the professionals, the parents had also noted the sign but did not recognise the significance.
"Parents are in an ideal position to act as screeners and although often aware of a physical sign of DDH do not realise it. We believed that given the information, knowledge and guidance parents could carry out simple but diagnostically effective observations on their baby.
“We developed a self-check guide that empowered parents with basic, but vital knowledge to identify common signs of the condition. After a trial, and discussion with local Health Visitors and GPs to gain their acceptance due to the possible increase in patient queries, our maternity unit began giving a copy of the guide to every newborn infant's parents.
We than monitored referrals to the clinic and using hospital data it has been possible to identify infants referred by their GP due to parents concern through identification of highlighted factors from the parents self-check guide,” continued Angela.
The number of infants identified with a positive hip dysplasia at the first clinic appointment averages 168 infants (20%) per year. Of those infants identified with DDH, between 5-10% were those recognised by parents due to being aware of the risk factors. The average age of infants referred was between 4-7 months with the mean age being 5.36 months.
The scheme is now part of the normal process for our infant patients, and through the sharing of good practice has been adopted by a number of other Trusts.