Innovative postnatal risk assessment in preventive child health Care: A study protocol

J Adv Nurs. 2020 Dec;76(12):3654-3661. doi: 10.1111/jan.14547. Epub 2020 Sep 30.

Abstract

Aim: To introduce the rationale and design of a postnatal risk assessment study, which will be embedded in Preventive Child Health Care. This study will evaluate: (a) the predictive value of an innovative postnatal risk assessment, meant to assess the risk of growth and developmental problems in young children; and (b) its effectiveness in combination with tailored care pathways.

Design: This study concerns a historically controlled study design and is designed as part of the Healthy Pregnancy 4 All-2 program. We hypothesize that child growth and developmental problems will be reduced in the intervention cohort due to the postnatal risk assessment and corresponding care pathways.

Methods: The study was approved in August 2016. Children and their parents, visiting well-baby clinics during regular visits, will participate in the intervention (N = 2,650). Additional data of a historical control group (N = 2,650) in the same neighbourhoods will be collected. The intervention, consisting of the risk assessment and its corresponding care pathways, will be executed in the period between birth and 2 months of (corrected) age. The predictive value of the risk assessment and its effectiveness in combination with its corresponding care pathways will be assessed by Preventive Child Health Care nurses and physicians in four Preventive Child Health Care organisations in three municipalities with adverse perinatal outcomes. A total risk score above a predefined threshold, which is based on a weighted risk score, determines structured multidisciplinary consultation.

Discussion: The successful implementation of this innovative postnatal risk assessment including corresponding care pathways has potential for further integration of risk assessment and a family-centred approach in the work process of Preventive Child Health Care nurses and physicians.

Impact: This study introduces a systematic approach in postnatal health care which may improve growth and developmental outcomes of children and even future generations.

目的: 介绍产后风险评估研究的原理和设计,该风险评估研究将纳入儿童预防保健。该研究将评估:(a)创新型产后风险评估的预测价值,目的是评估幼儿生长发育问题的风险;和(b)该研究与定制的护理途径相结合的有效性。 设计: 本研究涉及一项历史对照研究设计,是作为健康孕期4 All-2计划的一部分。我们假设,由于产后风险评估和相应的护理途径,干预队列中的儿童生长和发育问题将减少。 方法: 该研究于2016年8月获得批准。在定期就诊期间到健康儿童门诊就诊的儿童及其父母将参与干预(N = 2650)。将收集同一街区的历史对照组(N = 2,650)的其他数据。干预措施包括风险评估及其相应的护理途径,将在幼儿出生后至2个月(校正)年龄期间执行。风险评估的预测价值及其与相应护理途径相结合的有效性,将由三个不良围产期结局的城市的四个儿童预防保健组织的护士和医生进行评估。超过预定义阈值的风险总分(根据加权风险分值)确定结构化多学科咨询。 讨论: 本创新型产后风险评估(包括相应的护理途径)的成功实施,有可能进一步将风险评估和以家庭为中心的方法纳入儿童预防保健护士和医生的工作过程中。 影响: 本研究在产后保健中引入了一种系统化方法,可以改善儿童乃至后代的生长发育结果。.

Keywords: care pathway; child growth and development; interdisciplinary collaboration; preventive child health Care nurses; preventive child health Care physicians; preventive nursing; risk assessment.

MeSH terms

  • Child
  • Child Health*
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Postnatal Care
  • Pregnancy
  • Preventive Health Services*
  • Referral and Consultation
  • Risk Assessment
  • Risk Factors