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Screening for developmental dysplasia of the hip in a rural health district: An analysis of practice.

Screening for developmental dysplasia of the hip in a rural health district: An analysis of practice.
Author Information (click to view)

Wright S, Cotterell E, Schmidt D,


Wright S, Cotterell E, Schmidt D, (click to view)

Wright S, Cotterell E, Schmidt D,

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The Australian journal of rural health 2017 11 23() doi 10.1111/ajr.12400
Abstract
OBJECTIVE
To describe hip dysplasia screening practices in a local rural health district.

DESIGN
Cross-sectional study of hospital birth records, local physiotherapy records, public community health electronic medical record (Community Health Information Management Enterprise database) and a survey of local clinicians who work with infants and children.

SETTING
Three rural public hospitals and community health centres in a New South Wales health district.

PARTICIPANTS
Birth records (n = 196) from March 2012 to May 2012; attendance at child and family nurse checks (n = 788) May 2013-April 2014; 13 cases of managed developmental dysplasia of the hip (DDH) 2012 and local clinicians (n = 49).

RESULTS
At birth, the majority of infants (91%, 179/196) had documented hip screening. Community health records show this dropped to 75% (587/788) at 1-4 weeks and 29% (227/788) at 6-8 weeks. A survey of local clinicians (54% response rate; 49/91) revealed most (78%) screen for DDH and less than half (43%) use guidelines. Almost all (97%) clinicians reported screening for DDH at 6-8 weeks of age. Only 51% of clinicians reported having specific training for DDH screening and 76% would like further training. The rate of late DDH requiring management in 2012 was 0.87% (7/806) and the rate of late DDH requiring surgery was 0.25% (2/806).

CONCLUSION
DDH screening practices are well established at birth in the rural health district. There is variability in DDH screening practices beyond 8 weeks of age. Clinicians report variations in their knowledge and training. Training in DDH screening and hip screening prompts added to the personal health record might improve rates of DDH screening beyond 8 weeks of age.

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