Developmental Screening in the Primary Care Setting: A Qualitative Integrative Review for Nurses

Abstract

Standardized developmental screening leads to the identification of children with developmental delays who may benefit from early intervention. Many children with developmental delays are not identified early in life. An integrative review was performed to synthesize and critically analyze qualitative studies on the developmental screening experiences of parents and providers to develop a deeper understanding of the developmental screening gaps in clinical practice and increase awareness among healthcare professionals who care for children. Qualitative studies written in English that focused on developmental screening in children from birth to school age and that included registered nurses, advanced practice nurses, pediatric or family physicians, or parents were considered. Ten studies met the inclusion criteria. The analysis resulted in four main themes: developmental screening behaviors, developmental screening barriers, developmental screening facilitators, and parent interactions. Positive parent interactions and practice-wide engagement facilitated successful implementation of standardized developmental screening in primary care settings. Barriers associated with developmental screening included time, lack of reimbursement, poor communication with parents, and unfamiliarity with developmental screening instruments. A limited number of studies have examined developmental screening methods used by advanced practice nurses. Only two studies in the review included advanced practice nurses. The developmental screening experiences of providers and parents increases awareness about the challenges associated with conducting developmental screening in primary care. Recommendations for future research are offered with a focus on advanced practice nurses in primary care.