An exploration of nurses' experiences of delivering the before school check : a thesis presented in partial fulfilment of the requirements for the degree of Master of Philosphy in Nursing at Massey University, Albany, New Zealand
The New Zealand Well Child/Tamariki Ora (WCTO) programme is a community based
well child health service; the programme is supported through the WCTO Framework and
an associated National Schedule. The schedule outlines a total of 12 core contacts that
every child and their family are entitled to receive from birth to five years. The first four of
these are provided by the child’s lead maternity caregiver, with the remainder contracted
out to Well Child Providers.
The Before School Check (B4SC) is the eighth and final core contact under the WCTO
schedule and is performed between 4 and 5 years of age. The B4SC was initiated in
September 2008 and utilises not only a developmental screening questionnaire but also a
health assessment, behavioural screen, hearing and vision assessment and oral health
screen. This check is not necessarily always delivered by the child’s well child provider but
can also be done through their family doctor or practice nurse.
The purpose of this study was to explore nurse’s experiences of implementing and
delivering the B4SC. Since its implementation in 2008 the B4SC has been delivered in a
variety of ways by a range of nurses across the country. This study focused on the
experiences of nurses working in Auckland and the participants included practice nurses,
plunket nurses and public health nurses. Using semi-structured interviewing the
participants in this study were given the opportunity to share their experiences and to
discuss any issues raised. Based on their experiences participants were also asked if they
had any recommendations for the further development of the B4SC.
Thematic analysis using a general inductive approach was used to analyse the data and a
number of themes emerged. Although the participants were very positive about the
potential benefits of the check they expressed a range of challenges in the delivery of it.
Five key themes were identified entitled: Construct constraints, Time, Translation &
Culture, Child Interaction and Training & Support. Recommendations are made based on
the study findings and suggestions for further research are presented.