Abstract
Developmental Dysplasia of the Hip (DDH) captures a range of hip disorders which requires early identification and management and as such is a significant public health and primary care issue. The incidence of late diagnosis is higher in Ireland that other countries. Hip ultrasound is not widely practiced in Ireland. After birth, Public Health Nurses (PHNs) practitioners in Ireland may be the first health professional to be alerted to a missed case of DDH. The aim of this paper is to use a case study to illustrate the complexities of public health nursing practice with parents to screen, intervene and manage DDH. The paper highlights the way in which PHNs fulfil their public health role by implementing interventions, at the level of individuals, communities and systems, to address public health issues, informed by the Public Health intervention Wheel (The Wheel). Implications for education and practice are also discussed.
Highlights
Detection of Developmental Dysplasia of the Hip (DDH) is a complex issue
Public Health Nurse (PHNs) practitioners may be the first health professional to be alerted to a missed case of DDH
DDH is an important population health issue with a high incidence of late diagnosis leading to poorer outcomes in Ireland compared to other European countries
Summary
Detection of Developmental Dysplasia of the Hip (DDH) is a complex issue. The use of ultrasound as a screening method for DDH was first described by Graf in the 1980’s [2]. Diagnosis of DDH is possible within the first few weeks of life through clinical examination by experienced clinicians and ultrasound. Children should be treated by 3-4 months of age. The incidence of late diagnosis (after 3 months of age) and surgical intervention is higher in Ireland that other countries [3]. There is no national ultrasound screening programme for DDH in Ireland. Hip ultrasound examination is not widely practiced as not all regional hospitals have access to the facility for infants at 6 week of age (Health Service Executive (HSE) [4]
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