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Screening Accuracy for Developmental Dysplasia of the Hip by Child Health Nurses
Larissa Smart1,2, William Cundy3, Nicole Williams3
1School of Nursing, University of Tasmania, Locked Bag 3513, Burnie, TAS 7320, Australia.
Insights
Child health nurses in Australia cannot accurately screen for Developmental Dysplasia of the Hip (DDH) using physical assessment alone. Further investigation into nursing practices is needed to improve infant hip screening accuracy.
Area of Science:
- Pediatrics
- Orthopedics
- Public Health
Background:
- Developmental Dysplasia of the Hip (DDH) is a spectrum of hip joint abnormalities detectable in infancy.
- In Australia, child health nurses primarily use physical assessment for DDH screening.
- Accurate infant screening is crucial for timely DDH diagnosis and management.
Purpose of the Study:
- To evaluate the accuracy and utility of physical assessment by Australian child health nurses for DDH screening.
- To compare the effectiveness of physical assessment against handheld ultrasound for DDH detection in infants.
Main Methods:
- An Australian point prevalence study involving 44 participants.
- Comparison of DDH screening accuracy between child health nurses' physical assessment and handheld ultrasound devices.
Main Results:
- Child health nurses demonstrated low accuracy in physical assessment for DDH screening.
- Sensitivity was 50.5%, specificity 75.0%, and overall accuracy 71.3% for physical assessment.
- These findings indicate limitations in relying solely on physical assessment for infant DDH screening.
Conclusions:
- Physical assessment by child health nurses is insufficient for accurate DDH screening in infants.
- Further research is required to understand the role of education, experience, and assessment methods in improving DDH screening by nurses.
Background:
Developmental Dysplasia of the Hip (DDH) describes a spectrum of abnormalities that impact the normal function of the joint. These abnormalities are detectable during infancy using physical assessment, universal ultrasound, or a combination of both. In Australia, child health nurses predominantly screen for this disease using physical assessment. The aim of this study was to determine if child health nurses can accurately screen for DDH using physical assessment.
Methods:
This Australian study estimated the accuracy and utility of child health nurses using physical assessment to screen for DDH by comparing it to a handheld ultrasound device.
Results:
This study (N = 44) concluded that using a point prevalence study design, child health nurses in Australia are unable to accurately assess for DDH in infants using physical assessment; overall, clinicians had 50.5% sensitivity (95% CI, 15.7 to 84.3), a specificity of 75.0% (95% CI, 57.8 to 87.9), and 71.3% accuracy (95% CI, 55.6 to 83.9).
Conclusion:
This study suggests that child health nurses cannot screen for DDH using physical assessment. Understanding education, experience and what assessments are used suggests that the utility of nurses performing DDH screening requires further investigation.
