Early identification of infants at risk of cerebral palsy: developing the use of general movement assessment in routine clinical practice in a tertiary neonatal unit in New Zealand.


Journal

The New Zealand medical journal
ISSN: 1175-8716
Titre abrégé: N Z Med J
Pays: New Zealand
ID NLM: 0401067

Informations de publication

Date de publication:
08 05 2020
Historique:
entrez: 8 5 2020
pubmed: 8 5 2020
medline: 14 7 2020
Statut: epublish

Résumé

Preterm infants have a high risk of neurodevelopmental disability, including cerebral palsy (CP). Often, CP is not diagnosed until after 12 months, leading to delay in targeted interventions. The General Movements assessment (GM) evaluates the spontaneous movements of high-risk infants from birth to 20 weeks corrected postnatal age (CPA), and accurately predicts the risk of CP. This allows for earlier diagnosis and intervention, potentially changing the trajectory of disability, yet routine use of GM is not well established in New Zealand. To describe the process of setting up GM in a tertiary neonatal unit. We reviewed the process and progress made to date setting up GM in our service. Challenges and potential solutions for the implementation of GM were identified. Key areas of development included staff training and support, IT services, resources, medical documentation, inter-departmental communication and establishing clinical pathways. GM has become successfully integrated into the assessment of high-risk infants in our neonatal unit, with the aim to provide valuable information to health professionals and families to optimise intervention and improve outcomes. Efforts will continue to ensure there is robust and sustainable system for using GM in our service.

Sections du résumé

BACKGROUND
Preterm infants have a high risk of neurodevelopmental disability, including cerebral palsy (CP). Often, CP is not diagnosed until after 12 months, leading to delay in targeted interventions. The General Movements assessment (GM) evaluates the spontaneous movements of high-risk infants from birth to 20 weeks corrected postnatal age (CPA), and accurately predicts the risk of CP. This allows for earlier diagnosis and intervention, potentially changing the trajectory of disability, yet routine use of GM is not well established in New Zealand.
AIM
To describe the process of setting up GM in a tertiary neonatal unit.
METHODS
We reviewed the process and progress made to date setting up GM in our service.
RESULTS
Challenges and potential solutions for the implementation of GM were identified. Key areas of development included staff training and support, IT services, resources, medical documentation, inter-departmental communication and establishing clinical pathways.
CONCLUSION
GM has become successfully integrated into the assessment of high-risk infants in our neonatal unit, with the aim to provide valuable information to health professionals and families to optimise intervention and improve outcomes. Efforts will continue to ensure there is robust and sustainable system for using GM in our service.

Identifiants

pubmed: 32379740

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

63-70

Déclaration de conflit d'intérêts

Nil.

Auteurs

Meghan Sandle (M)

Paediatric Registrar, Capital and Coast DHB, Wellington; MSc student, Paediatrics and Child Health, University of Otago, Wellington.

Alison Sheppard (A)

Neurodevelopmental Physiotherapist, Capital and Coast DHB, Wellington.

Angelica Allermo Fletcher (AA)

Consultant Neonatologist, Capital and Coast DHB.

Max Berry (M)

Consultant Neonatologist, Capital and Coast DHB, Senior Lecturer, Paediatrics and Child Health, University of Otago.

Nathalie DeVries (N)

Consultant Paediatrician. MidCentral District Health Board, Palmerston North.

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