Nursing Care for Disability Prevention (Audiology / Hearing Screening)

Program Steps:

1. Screening: Conducted in the first week of life (ideally with thyroid screening) using Otoacoustic Emissions (OAE). If failed, it is repeated after 1–2 weeks.
2. Procedure: Performed by a trained nurse in a quiet room, testing each ear separately (max 3 attempts per ear).
3. Timeline: Screening must be completed within 28 days.
4. Documentation: Results are recorded in the designated register.
5. Referral: If the child fails the second test, they are referred to a specialized audiology clinic in a public hospital.

Requirements:

• Training nurses on OAE device usage and data recording.
• Providing OAE devices and designated testing rooms.
• Educating families on the importance of early detection and ensuring follow-up through supervisors.

Otoacoustic Emissions (OAE) Device

 Field Monitoring and Follow-up Form

Monitor/Supervisor Name: ........................................ Primary Health Care Unit (PHCU): .......................... Month: .......................................................................

Additional Notes:

Monitor’s Comments and Recommendations: ......................................................

Monitoring and Follow-up Form User Guide

1. Registering children in the general screening log:

• Good: Immediate registration for all children.
• Acceptable: Immediate registration for some; delayed for others.
• Unacceptable: Not all children are registered.

2. Complete and accurate use of the screening tool:

• Good: Screening is age-appropriate; all sections are completed during the screening session.
• Acceptable: Developmental milestones for other age groups are used and/or the decision is finalized later.
• Unacceptable: Not all sections are completed (i.e., preliminary data, risk factors, developmental milestones, decision).

3. Recording screening results in the designated registers:

• Good: Immediate, accurate recording for all children in the correct registers.
• Acceptable: Accurate recording for all children in the correct registers, but at a later time.
• Unacceptable: Not all children are recorded, or the recording is inaccurate/in the wrong registers.

4. Ratio of screened infants to total outpatients:

• Good: > 75%.
• Acceptable: 25% – 75%.
• Unacceptable: < 25%.

5. Percentage of positive cases among those screened:

• Good: 5% – 20%.
• Acceptable: 1% – 5% or 20% – 30%.
• Unacceptable: < 1% or > 30%.

6. Physician review of positive cases:

• Good: Physician reviews all positive cases and signs them personally.
• Acceptable: Physician reviews approximately half of the positive cases and delegates the rest to nursing staff.
• Unacceptable: Physician is unavailable, or present but does not review cases.

7. Systematic implementation of the screening process:

• Good: Children enter the screening area one by one.
• Acceptable: No more than (5) children enter the screening area, organized in a queue.
• Unacceptable: More than (5) children in the screening area and/or no organized queue.

8. Maintaining children's screening forms:

• Good: All forms are perfectly organized in the appropriate files (Referral, Follow-up, Negative).
• Acceptable: All forms are filed appropriately (Referral, Follow-up, Negative) but are not perfectly organized.
• Unacceptable: All or some forms are not filed in the appropriate folders.