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

Abstract

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.