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									                                                          Health Visiting Health Education Programme
                                                                   ACCIDENT PREVENTION (0-4 YEARS)
    VISIT           ASSESSMENT                   ADVICE               DELIVERED                WHERE              TRAINING           NATIONAL/PCT                  RESOURCES
                                                                          BY                                       NEEDS               TARGET
Ante Natal      Smoke alarms/carbon         Tailor advice          Health Visiting team   Ante natal clinic    Domestic violence     DOH “Saving Lives       Women‟s Aid/ Domestic
                monoxide monitors           according to           Midwife                Home Visit           training              Our Healthier           Violence Unit
                Domestic Violence           individual needs                              GP Practice          Health and Safety     Nation” {2001}          The Accident Notebook
                Sleeping arrangements                                                     Children‟s Centres   training              In which accident       {1997}
                Seat belt wearing in                                                      Sure Start                                 prevention was          PCHR
                pregnancy                                                                                                            highlighted as 1 of 4   Birth to 5 NHS – Health
                                                                                                                                     priority areas:         Education Authority {2001}
                                                                                                                                     Targets 2010 –
                                                                                                                                     reduce death rate
                                                                                                                                     from accidents by
                                                                                                                                     1/5th
Primary Visit   Check bedding               Bed sharing            Health Visiting team   Home visit           Cot death            DOH “Saving Lives        DOH Cot-Death leaflets
                In car safety               Passive smoke          Midwife                Health Clinic        prevention up-date   Our Healthier            “The Foundation for the
                Shaking Baby                Burns from hot         Sure Start Workers     Children‟s Centre    research papers      Nation” {2001}           study of infant deaths
                Cot death prevention        feeds and bath         Homestart              Sure Start           Relevant DOH         Targets 2010:            {FSID}”
                Passive smoke               Fire safety                                                        Policy               reduce death rate        www.dh.gov.uk/publications
                Need smoke alarm            Smoking                                                            PCT Guidelines       from accidents by        The Child Accident
                A & E notifications                                                                            Smoking cessation    1/5th                    Prevention Trust {CAPT}
                                                                                                               training             Reduce rate of           Leaflet “I‟m only a baby
                                                                                                                                    serious injury by        but….” DOH/ Sure start
                                                                                                                                          th
                                                                                                                                    1/10                     Publication 2005
                                                                                                                                    HoBtPCT Local
                                                                                                                                    Delivery Plan 2005-      {0207 608 7368}
                                                                                                                                    2008
6-8 weeks       Wriggles and kicks          Suffocation from       Health Visiting team   Home visit           HoBtPCT internal      United Nations          Health Protection Agency
contact         Rolls over                  tight strings, cords   CMO                    Health Clinic        Health & Safety       standard ECE            http://www.rospa.com
                Needs smoke alarms          on clothing            Sure Start Workers     Children‟s Centre    Training              Regulation 44-03        ROSPA fact sheets
                Raise awareness on          Burns from hot feeds                          GP Practice          Smoking Cessation     {Child Car Seats}       Child Surveillance Manual
                dangers of „prop‟ feeding   and bath                                                           training              DOH {2003}              {Birmingham Health
                In car safety                                                                                  HoBtPCT Internal      “Getting The Right      Authority 1997}
                A & E notifications                                                                            Risk Management       Start. The National     www.childcarseats.org.uk
                                                                                                               Training              Service Framework       www.injuryprevention.com
                                                                                                                                     For Children, Young     Health Protection Agency
                                                                                                                                                             http://www.rospa.com
                                                                                                                                     People & Maternity
                                                                                                                                     Services. Emerging
                                                                                                                                     Findings”
                                                                                                                                     HoBtPCT Local
                                                                                                                                     Delivery Plan 2005-
                                                                                                                                     2008




                                                                                                                                                                                        38
                                                       Health Visiting Health Education Programme
                                                                ACCIDENT PREVENTION (0-4 YEARS)
3/4/5 months   Discuss age related       Discuss common          Health Visiting team   Home visit           Relevant DOH Policy      DOH {2002}               www.injuryprevention.com
con+tact       accidents                 accidents to raise      Sure Start Workers     Health Clinic        PCT Guidelines           “Preventing              Health Protection
               Rolls over                awareness               Homestart              Children‟s Centre    HoBtPCT Internal         accidental injury –      Agency
               Puts objects in mouth     Falls from raised                              Local library        Health and Safety        priorities for action”   http://www.rospa.com
               Needs smoke alarms        surfaces eg bed,                               Mother and Toddler   training                 Report to:               ROSPA fact sheets
               A & E notifications       choking on pins,                               Groups                                        The Chief Medical        Child Health
                                         buttons, food                                  CDCs                                          Officer, The             Surveillance Manual
                                         In car safety                                  GP Practice                                   Accidental Injury        {Birmingham Health
                                                                                                                                      Task Force, London,      Authority 1997}
                                                                                                                                      TSO
6-9 months     Discuss age related       Sharp toys, scalds,     As above               As above             As above                 DOH {1999} “Saving       National Network For
contact        accidents                 burns from fire,                                                                             Lives: Our Healthier     Child Care
               Rolls/crawls and starts   heaters and                                                                                  Nation”                  www.nncc.org
               walking                   radiators                                                                                    The Stationary           The Accident Notebook
               Injury by siblings        Fit fireguard around                                                                         Office,                  {1997}
               Drowning in bath          heaters, stairgates                                                                          London                   PCHR
               Reaching for hot cups     In car safety                                                                                HoBtPCT Local            Birth to 5 NHS – Health
               Needs smoke alarms                                                                                                     Delivery Plan 2005-      Education Authority
               A & E notification                                                                                                     2008                     {2001}
                                                                                                                                      HoBtPCT Local A &        www.childcarseats.org.uk
                                                                                                                                      E Statistics
24– 7 months   Discuss age related       Plastic bag dangers     Health Visiting Team   Home visit           HoBtPCT                  DOH {2202}               The Child Accident
contact        accidents                 Walking in the road     Sure Start Workers     Health Clinic        Resuscitation            “Preventing              Prevention Trust {CAPT}
               Walking upstairs          Open pond               Homestart              Children‟s centre    training and first aid   Accidental Injury –      www.capt.org.uk
               Exploring                 Paddling pool           Day nurseries          Local library        Relevant DOH Policy      Priorities For Action”   Royal Society For The
               Imitative play            In car safety                                  Mother and Toddler   HoBtPCT Local A &        Report to the:           Prevention Of Accidents
               Need smoke alarms         Opens cupboards                                Groups               E Statistics             Chief Medical Officer    http://www.rospa.com
               Poisonous plants          May eat or drink                               GP Practice                                   The Accidental Injury    The Accident Notebook
               Road safety               hard boiled sweets                             Nurseries/Schools                             Task Force, London,      {1997}
               Choking and suffocation   or nuts                                                                                      TSO                      PCHR
               A & E notifications                                                                                                    HoBtPCT Local            Birth to 5 NHS – Health
                                                                                                                                      Delivery Plan 2005-      Education Authority
                                                                                                                                      2008                     {2001}
3–4 years      Discuss age related       Uses matches and        Health Visitor         Home visit           Relevant DOH Policy      DOH {2003} “Getting      The Accident Notebook
contact        accidents                 lighters                Nursery schools        Health Clinic        PCT Guidelines           The Right Start. The     {1997}
               Needs smoke alarms        May open child          Nursery                Children‟s centre    HoBtPCT Internal         National Service         PCHR
               Drowning                  resistant tops and      Nurses/Link workers    Mother and Toddler   Health & Safety          Framework For            Birth to 5 NHS – Health
               Road Safety               blister packs           Sure Start workers     Groups               training                 Children, Young          Education Authority
               In car safety             Walking in the road     Homestart              GP Practice                                   People & Maternity       {2001}
               A & E notifications       Open pond               Day nurseries          Nurseries/Schools                             Services. Emerging       Child Health Surveillance
                                         Paddling pool                                                                                Findings”                Manual {Birmingham
                                                                                                                                      HoBtPCT Local            Health Authority l997}
                                                                                                                                      Delivery Plan 2005-      www.dh.gov.uk/publications
                                                                                                                                      2008


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                                                          Health Visiting Health Education Programme
                                                                                        ASTHMA
                    ASSESSMENT                     ADVICE                DELIVERED               WHERE         TRAINING       NATIONAL/PCT             RESOURCES
    VISIT                                                                    BY                                 NEEDS           TARGET
Ante Natal      Definite diagnosis of        Importance of            Practice Nurse       Surgery         Regular updates   Optimal management      The BTS/NICE
                asthma {Mother}              concordance with         GP                   Health Centre   In-house asthma   of long term chronic    guidelines
                Assess asthma control        treatment.               Or other Health                      training          health conditions, in   NICE guidelines
                                             Check inhaler            Professional                                           accordance with         Websites
                                             technique.               Include asthma                                         Government Paper        Asthma UK
                                             Maintain wellbeing.      training                                                                       British Lung
                                             Smoking cessation                                                                                       Foundation
Primary Visit   Note any other respiratory   Encourage breast –       As above             Surgery         Regular updates                           As above
                problems ie whooping         feeding                                       Health Centre   In-house asthma
                cough/broncholitis/croup     Importance of                                 Home            training
                                             attending reviews
                                             Dispel any fears/
                                             worries re: taking
                                             medication
6-8 weeks       Monitor respiratory          To attend regular        Practice Nurse       Surgery         Regular updates                           As above
contact         symptoms to aid diagnosis    reviews incompliance     GP                   Health Centre   In-house asthma
                                             with medication          Or other Health                      training
                                                                      Professional

3/4/5 months    Monitor respiratory          Importance of            Practice Nurse       Surgery         Regular updates                           As above
contact         symptoms to aid diagnosis    concordance,             GP                   Health Centre   In-house asthma
                                             including treatment      Or other Health      Home            training
                                             and correct inhaler      Professional
                                             technique                Include asthma
                                                                      training
6-9 months      Monitor control of           As above                 Practice Nurse       As above        As above                                  As above
contact         respiratory symptoms/                                 GP
                asthma                                                Or other Health
                                                                      Professional
                                                                      Include asthma
                                                                      training
24-27 months    Monitor control of           Reinforce previous       As above             As above        As above                                  As above
contact         respiratory symptoms/        advice
                asthmas
3-4 years       Monitor control of asthma    Educate parents re:      As above             As above        As above                                  As above
contact                                      how to use spacer
                                             with inhaler, also how
                                             to handle acute
                                             attack and
                                             importance of an
                                             asthma review


                                                                                                                                                                       40
                                                          Health Visiting Health Education Programme
                                                                                BREASTFEEDING
    VISIT            ASSESSMENT                    ADVICE                DELIVERED                 WHERE                TRAINING             NATIONAL/PCT               RESOURCES
                                                                             BY                                          NEEDS                 TARGET
Ante Natal      Planned method of feeding    Discuss benefits of      Midwives              Home                    UNICEF breast –         Increase initiation 2%   UNICEF breast –
                                             breastfeeding for both   Health Visitors       Ante-natal support      feeding management      per year                 feeding leaflets
                                             Mother and Baby          Breastfeeding peer    groups                  course 3 or 2 days in   Increase sustain –       Best Buddy leaflets
                                             Availability of Best     support worker        Ensure groups are       house                   ability to 6 months      Breastfeeding {NHS
                                             Buddies                                        culturally sensitive,   Best Buddy course       {Good practice &         leaflet}
                                                                                            represent the           Cultural aspects of     innovation in breast-    Video/CD/books
                                                                                            community in which      breastfeeding           feeding DOH 2005         {some resources
                                                                                            they serve {BME,                                NSF Guidelines           available from Under
                                                                                            single parents, low                             World Health             5s or Sure Start
                                                                                            income families}                                Organisation}            programmes}
                                                                                                                                                                     Breastfeeding leaflet
                                                                                                                                                                     for the Muslim
                                                                                                                                                                     community
                                                                                                                                                                     National Childbirth
                                                                                                                                                                     Trust (NCT)
                                                                                                                                                                     La Leche League
Primary Visit   Chosen method of feeding     Reaffirm benefits of     Health Visitor        Home                    UNICEF breast –         Increase sustain –       UNICEF breast –
                Positioning and attachment   breastfeeding                                                          feeding management      ability to 6 months      feeding leaflet
                Support                      Discuss                                                                course 3 or 2 days in   {Good practice &         Best Buddy leaflet if
                DATA COLLECTION              breastfeeding support                                                  house                   innovation in breast –   not already given
                                             from Best                                                                                      feeding DOH 2005         NCT
                                             Buddies/Family                                                                                 NSF guidelines           La Leche League
                                             support                                                                                        World Health
                                             Inform re: local                                                                               Organisation}
                                             breastfeeding support
                                             groups
6-8 weeks       Method of feeding            Local available          Health Visitor team   Home                    UNICEF breast –         As above                 NCT
contact         Support available            support                                        Clinic                  feeding management                               La Leche League
                DATA COLLECTION                                                             Children‟s centre       course 3 or 2 days in
                                                                                            Nursery                 house
                                                                                            Sure Start              Best Buddy course
3/4/5 months    Method of feeding            Reaffirm benefits of     Health Visitor team   Home                    UNICEF breast –         As above                 UNICEF breast –
contact         Plans to return to work      breastfeeding            Breastfeeding peer    Baby clinic             feeding management                               feeding leaflet
                                             Discuss support eg       support worker        Post natal support      course 3 or 2 days in                            Best Buddy leaflet if
                                             Best Buddies/family                            groups                  house                                            not already given
                                             support/local breast-                          Baby cafes                                                               NCT
                                             feeding support                                Breastfeeding                                                            La Leche League
                                             groups                                         support groups
6-9 months      Assess and discuss           Reaffirm benefits of     Health Visitor team   As above                                        As above                 Weaning leaflets
contact         correct feeding equipment    breastfeeding to 6                                                                                                      Weaning
                                             months                                                                                                                  demonstration
24-27 months
contact
3-4 years                                                                                                                                                                               41
contact
                                                            Health Visiting Health Education Programme
                                                                               DOMESTIC VIOLENCE
    VISIT           ASSESSMENT                      ADVICE                 DELIVERED                     WHERE       TRAINING             NATIONAL/PCT               RESOURCES
                                                                               BY                                     NEEDS                 TARGET
Ante Natal      Assess relationship of        Offer opportunity to      Health Visitor          Home             PCT Domestic            Pregnancy                 Birmingham specific
                parents                       talk about relationship   Midwife                 Clinic           Violence training       associated with           emergency Women‟s
                Assess extended family/       and previous              Ante natal classes      GP               course                  increased risk of         Aid phone numbers
                friends support.              experience with                                   Surgery          Relationship with       domestic violence         Domestic Violence –
                Offer Mother opportunity to   children                                                           Police Domestic         G Bewley/S Friend/ J      a resource manual for
                discuss any abuse             Offer anticipatory                                                 Violence Unit           Mezey                     healthcare workers.
                Note any history of           advice about relation-                                                                     Violence against          DOH London HMSO
                depression                    ship changes with                                                                          women-London              2000
                Coordinate information        birth of a child                                                                           RCOG Press 1997           PCT Domestic
                from Midwives/GP/Health       Emergency contact                                                                          Victims often present     Violence training
                Visitor and Social            numbers for                                                                                with depression BMA
                Services.                     Women‟s Aid                                                                                Domestic violence a
                Note ante natal               Services                                                                                   healthcare issue
                appointment                                                                                                              London BMA 1998
                DNAs
Primary Visit   Handover from community       Ask about domestic        Health Visitor          Home             UNICEF breast           1 in 4 woman              As above
                Midwife                       violence and              Best Buddies team to    Clinic           feeding course to       experience domestic       Domestic Violence
                Assess relationship and       relationship              support breastfeeding                    support breastfeeding   violence in their life    guidance for nurses
                Father reaction to baby       difficulties              Under 5s team                            PPP training            6.5m domestic             Royal College of
                Assess extended family        Other regular support                                              and as above            violence assaults a       Nursing London 2000
                and friends support.          visits                                                                                     year
                Assess baby – content or      Emergency telephone                                                                        Home Office – DV
                difficult eg crying/colic/    numbers – sticker for                                                                      findings from a new
                feeding difficulties          red book                                                                                   British Crime Survey.
                Assess Mother‟s mood          Mother and baby                                                                            Home Office research
                                              group                                                                                      Where DV suspected
                                              Parenting skills                                                                           best to ask directly
                                              course
                                              Breastfeeding advice
¾/5 months      Assesses Mother and baby      Offer support visits      Health Visitor          Home             As above                Supporting the non-       As above
contact         relationship                  Offer opportunity to      Practice Nurse          Clinic                                   violent parent, usually
                Ask about relationship with   talk                                              GP                                       represents the most
                partner                       Mother and Baby                                   Surgery                                  effective way of
                Assess baby for               groups to prevent                                                                          promoting the welfare
                development and thriving      social isolation                                                                           of the child
                Monitor attendance for        PPP package.                                                                               DOH working
                immunisation                  Post natal check to                                                                        together to safeguard
                Note DNAs                     assess depression                                                                          children – London
                Monitor A&E attendances       Link A&E attendance                                                                        DOH 1999
                Monitor GP attendances        with Social Services,
                Assess Mother‟s mood           if necessary



                                                                                                                                                                                     42
                                                          Health Visiting Health Education Programme
                                                                              DOMESTIC VIOLENCE
6-9 months     Assess relationships         Offer support              As above         Clinic               As above   DV affects children,     As above
contact        Assess baby                  Visits                                                                      90% of incidents         Birmingham
               Monitor DNAs and A & E       Encourage stay and                                                          occur where children     Interagency DV
               attendance                   play/ support groups                                                        can witness it or        Forum
                                                                                                                        overhear it              Principles, Standards
                                                                                                                        Hughes H Impact of       and Good Practice.
                                                                                                                        spouse abuse on the      Birmingham
                                                                                                                        children of battered     Community Safety
                                                                                                                        women. Implications      Partnership 2004
                                                                                                                        for practice. Violence
                                                                                                                                          st
                                                                                                                        Update l992 – 1
                                                                                                                        August 9 - 11

24-27 months   Assess relationships         Offer support              Health Visitor   Clinic               As above   Children affected in
contact        Assess toddler social        Advise pre-school                                                           different ways-
               development and              play opportunities for                                                      dependent on age:
               behaviour                    child                                                                       physical injuries,
               Monitor DNAs and A & E       Triple P training if not                                                    emotional
               attendance                   previously taken up                                                         disturbances,
                                            Referral to other                                                           developmental delay
                                            agencies if necessary                                                       Hester M, Pearson C,
                                                                                                                        Harvin N – Making an
                                                                                                                        impact : Children and
                                                                                                                        DV; A Reader –
                                                                                                                        London DOH 1998
3-4 years      Assess child development     Support visits             Health Visitor   Pre-school setting   As above   The most important       As above
contact        and behaviour                Triple P training if not   Nursery Nurse    Home                            actions a health
               Monitor attendance at pre-   already taken up                                                            professional can
               school education             Referral to other                                                           take are to listen
               Monitor A & E attendance     agencies if necessary                                                       and signpost to
                                                                                                                        other agencies

                                                                                                                        Shakespeare J {DV};
                                                                                                                        A primary care issue
                                                                                                                        Nursing in Practice
                                                                                                                        Nov/Dec 2003; 35-37




                                                                                                                                                                   43
                                                         Health Visiting Health Education Programme
                                                                                       ECZEMA
    VISIT            ASSESSMENT                  ADVICE                 DELIVERED               WHERE         TRAINING          NATIONAL/PCT             RESOURCES
                                                                            BY                                 NEEDS              TARGET
Ante Natal      Definitive diagnosis of    Importance of             Practice Nurse       Surgery         Learn about skin     Optimal management      Archives of
                eczema {Mother}            concordance with          GP                   Health Centre   conditions           of long term chronic    Dermatology
                                           treatment.                Or other Health                      Regular updates      health conditions, in   Websites
                                                                     Professional                         In-house training    accordance with         Eczema Society UK
                                                                     Include eczema                                            Government Paper
                                                                     training
Primary Visit   Monitor skin condition,    Encourage breast –        Practice Nurse       Surgery         Regular updates                              As above
                noting symptoms to aid     feeding                   GP                   Health Centre   In-house training
                diagnosis                  Correct application of    Or other Health
                Encourage breastfeeding    emollients, observe       Professional
                                           for environmental         Include eczema
                                           triggers                  training
6-8 weeks       Monitor skin symptoms to   Continue with             Practice Nurse       Surgery         Regular updates                              As above
contact         obtain diagnosis and       prescribed skin care      GP                   Health Centre   In-house training
                observe effectiveness of   treatment                 Or other Health
                treatment                                            Professional

3/4/5 months    Monitor skin symptoms,     Encourage breast –        Practice Nurse       Surgery         Regular updates                              As above
contact         observe effectiveness of   feeding                   GP                   Health Centre   In-house training
                treatment                  Correct application       Or other Health
                                           emollients                Professional
                                           Avoid use of hard         Include eczrma
                                           detergents/perfume        training
6-9 months      Monitor skin symptoms,     Encourage breast –        Practice Nurse       As above        As above                                     As above
contact         observe effectiveness of   feeding                   GP
                treatment                  Correct application       Or other Health
                                           emollients                Professional
                                           Avoid use of hard         Include eczema
                                           detergents/perfume        training
                                           Cool cotton clothing
                                           Adequate
                                           moisterisation
24-27 months    Monitor skin conditions,   Monitor skin even         As above             As above        As above                                     As above
contact         observe effectiveness of   when in good
                treatment                  condition
3-4 years       Monitor skin conditions,   Ensure correct            As above             As above        Regular updates on                           As above
contact         observe effectiveness of   application of                                                 skin conditions
                treatment                  emollients, cool                                               In-house training
                                           cotton clothing, avoid
                                           harsh detergents,
                                           perfumed
                                           soaps/conditioners
                                           Adequate
                                           moisturisation of skin,                                                                                                     44
                                           even when skin is in
                                           good condition
                                                          Health Visiting Health Education Programme
                                                                        EQUIPMENT STERILISATION


    VISIT           ASSESSMENT                    ADVICE                 DELIVERED                 WHERE             TRAINING        NATIONAL/PCT             RESOURCES
                                                                             BY                                       NEEDS            TARGET
Ante Natal      Feeding choice              Options available         Midwife               Clinic              Generic training/   Sure Start target NSF   Worksheet
                Mother‟s level of           Promote breast-           Health Visitor team   Home                information         for children‟s health   {to be produced}
                understanding               feeding option            Sure Start worker     Children‟s centre                       {Health promotion
                Home/family                                                                                                         standard 1}
                circumstances
Primary Visit   Assessment of feeding       Correct methods/          Midwife               Home                Food Hygiene        NSF for children        Leaflets
                options                     process of                Health Visitor team                       Health/Safety       Standard 2              Worksheet or fact
                Encourage breast-feeding    sterilisation             Sure Start worker                         Sterilisation                               sheet {to be
                option                                                                                          techniques                                  produced}
6- 8 weeks      Reassess feeding method     As above                  Health Visitor team   Home                                    As above
contact                                                               Sure Start worker     Clinic
                                                                                            Children‟s centre
                                                                                            Nursery
                                                                                            Sure Start
3/4/5 months    Reassess feeding method     As above                  As above              As above                                As above
contact

6- 9 months     Assess and discuss          To continue sterilising   As above              As above                                As above
contact         correct feeding equipment   of bottle feeding
                                            equipment until 1
                                            year
24-27 months
contact

3-4 years
contact




                                                                                                                                                                                45
                                                             Health Visiting Health Education Programme
                                             HEALTH PROMOTION FOR SPEECH AND LANGUAGE DEVELOPMENT
    VISIT           ASSESSMENT                     ADVICE                 DELIVERED                WHERE                TRAINING            NATIONAL/PCT             RESOURCES
                                                                              BY                                         NEEDS                TARGET
Ante Natal      Anticipatory guidance        Advise that               Health Visiting team   Home                  Sure Start Speech      Every Child Matters   „Your bump & beyond‟
                around early baby needs      stimulating baby          Midwives               Ante natal support    and Language           NSF Standard 1        pack by the Sure Start
                Parental receptiveness to    before birth makes it     Sure Start Worker      groups                Team                                         Talkabout Team
                accept advice                easier for them to                               Sure Start premises   Cultural
                                             learn afterwards.                                Children‟s Centres    Competence
                                             Hearing and                                                            Training
                                             communication can
                                             be stimulated before
                                             birth

Primary Visit   Parenting experiences/       Draw attention to         Health Visitor         Home                   Research Papers        As above             „Talking Together‟ leaflets
                skills                       importance of baby        Midwife                Health Centre          Access relevant                             {Sure Start, Birmingham
                Evidence of bonding          having different          Sure Start Worker                             training by Speech                          City Council/PCT
                Child centred environment    sounds eg use of                                                        and Language                                Partnership 2003}
                Family circumstances         voice/gentle music/                                                     Team locally
                                             talking to baby/use                                                     Access Cultural
                                             of mobile                                                               Competence
                                                                                                                     Training
6–8 weeks       Parental appreciation of     Explain about:            Health Visiting team   GP premises           Access training by     As above              „Talking Together‟ leaflets
contact         use of voice, other sounds   Use of mobile             Home                   Health Centre         Local Speech and                             {Sure Start, Birmingham
                stimulating environment      Talking to baby           GP                     Home                  Language Team                                City Council/PCT
                                             Using eye contact                                Sure Start            {Sure Start}                                 Partnership 2003}
                                             Ways of creating                                 Children‟s Centre     SOGS Training                                „I Can Speech &
                                             bonding                                                                                                             Language Charity
                                                                                                                                                                 www.ican.org.uk
3/4/5 months    Attention to baby‟s          Advise about              Health Visiting team   As above              Research on support    As above              “National Literacy Trust
contact         growing speech and           importance of             GP Practice Nurse                            for parents with bi-                         2002” leaflet
                language needs.              listening to baby‟s                                                    lingual needs                                Raising your child bi-
                Vocalising                   sounds and                                                                                                          lingually
                Smiling                      encouraging baby to
                Laughing out loud            listen {brain
                                             development most
                                             rapid in first 2 years}
                                             Make eye contact
                                             with baby - smile
                                             Talk back
                                             Use of mobiles




                                                                                                                                                                                          46
                                                        Health Visiting Health Education Programme
                                         HEALTH PROMOTION FOR SPEECH AND LANGUAGE DEVELOPMENT
6–9 months     Baby‟s ability to pick    Explain that talking    Health Centre          Health Visiting team   SOGS Training        Book Start               „Talk To Your Baby‟
contact        up sounds                 helps babies to         Home                                          Access training by   Programme                www.talktoyourbaby.or.g.uk
               Baby‟s understanding      listen                  Sure Start premises                           local Speech and     DOH/Education
               of frequently used        Listening helps         Children‟s Centres                            Language Team        Partnership
               words                     babies learn to use                                                   Cultural
               Locating sounds           language                                                              Competence
               Enjoyment of sound        Play with baby and
               and rhymes                talk while playing
                                         Use nursery rhymes
                                         and books
                                         Songs with actions
24–27 months   Parental understanding    Advice to gain          Health Visiting team   Sure Start             SOGS Training        Government target        „Talk To Your Baby‟
contact        of child‟s speech and     child‟s attention       Home                   Children‟s Centre      Access training by   to increase              www.talktoyourbaby.or.g.uk
               communication needs       when you want to        Sure Start Workers     Health Centre          local Speech and     proportion of
               Child‟s environment       talk                                           Home                   Language Team        children having
               Level of language         Increase vocabulary                                                   Cultural             normal levels of
               development               by giving choices                                                     Competence           communication
               Use of books etc          Communication is                                                                           language and
                                                                                                                                                        rd
                                         basis of parent/child                                                                      literacy by end of 3
                                         relationship                                                                               year
                                         Help child use more                                                                        NSF Standard 1
                                         words by adding to
                                         what they say
3–4 years      Child‟s level of          Use of children‟s       Health Visiting team   Nurseries                                   Every Child Matters      Books :
contact        language development      centres                 Nursery                Health centre                               NSF                      Children‟s Common Skills
               Potential                 Nurseries               Sure Start Workers     Children‟s centre                           Government‟s Book        By Belinda Buckley
               understanding of          Spend special time                                                                         Start Programme          {Routledge 2005}
               methods to stimulate      with child reading/
               development               games/talk about TV
               Use of Local Children‟s   programmes
               Services                  together
                                         Respond to child
                                         when he/she talks




                                                                                                                                                                                    47
                                                            Health Visiting Health Education Programme
                                                                                   INFANT ANAEMIA

    VISIT           ASSESSMENT                      ADVICE                  DELIVERED                WHERE      TRAINING NEEDS           NATIONAL/ PCT             RESOURCES
                                                                                BY                                                          TARGET
Ante Natal      Hb check at initial booking   Give iron checklist for   Midwife             Clinic              Nutrition and dietary     (NSF for Children,   Iron checklist for
                Anaemia during                mums to be                                                        training and updates     Young People &        adults/children
                pregnancy is a high risk      Encourage healthy         Health Visitor      Home                                         Maternity Services    (Sure Start Nutrition
                for infant deficiency         diet Stress the                                                                            2001)                 Team)
                (Viteri et al 1997)           importance of vitamin
                                              C intake
                                              Reinforce dietary
                                              advice for vegetarians
                                              Ensure supplements
                                              taken
Primary Visit                                 Reinforce healthy diet    Health Visitor      Home                                                               Iron checklist as above
                                              message to all
                                              breastfeeding mums
                                              Refer to iron checklist
                                              for mums known to
                                              have low Hb
                                              antenatally
                                              Ensure premature or
                                              low birth weight
                                              babies receiving
                                              vitamin/iron
                                              supplements
6-8 weeks                                     Same as above             GP                  Clinic
contact                                                                 Health Visitor
                                                                        Practice Nurse
3/4/5 months    Higher incidence of infant    Delivery of weaning       Health Visitor      Well baby clinic    Nutrition, dietary and                         Weaning packs/leaflets
contact         anaemia found where           packs and dietary         Practice Nurse      Immunisation        weaning training –                             (Reinforce 3-4 month
                cows milk introduced          advice                    Community Nursery   Clinic              Community Dieticians                           contact leaflets (NSF)
                before 8 months of age        Emphasise weaning         Nurse               Children‟s Centre                                                  introduction of solids at
                (Aukett et al 1997)           foods rich in iron and                                                                                           6 months)
                                              vitamin C (increases
                                              absorption of iron)
                                              Increase emphasis on
                                              babies weaned onto a
                                              vegetarian diet
                                              Consider
                                              supplements where
                                              necessary
                                              Discourage the early
                                              introduction of cow‟s
                                              milk

                                                                                                                                                                                       48
                                                           Health Visiting Health Education Programme
6–9 months    Routine development            Include iron checklist   Health Visitor       Clinic              Cultural awareness    Infant Iron checklist
contact       screening                      and dietary advice       Community Nursery    Children‟s Centre   relating to dietary   Energy for Josh
              Offer Hb screening for         with developmental       Nurse                                    issues                teaching pack –
              those infants identified as    assessment               Staff trained in                         Angela Knight –       Under 5‟s team
              high risk                      Reinforce an iron rich   hemacue testing.                         Jackson               Trust Policy – Anaemia
              Screening may be more          diet for mother and                                               Community Dietician   training
              effective at 8 months due      baby in breastfeeding                                             Under 5 team
              to the adverse effect on       mums                                                              Hemacue Training -
              development caused by                                                                            Designated trainers
              low Hb
              (Sherif et al 2001)
24–27months   Developmental screening        Dietary advice and       Clinic               As above            As above              As above
contact       Opportunistic Hb check         importance of iron       Children‟s Centres
              where there are any            rich, varied diet re-    Toddler Parties
              concerns                       emphasised
              In the UK there is a higher    Discourage excessive
              incidence of iron              milk intake
              deficiency anaemia in
              children who consume
              over one litre of cow‟s milk
              (Aukett et all 1997)
3–4 years                                    Continue to              As above             As above                                  As above
contact                                      encourage well           Family –workers
                                             balanced and varied      Nursery nurses
                                             diet. Screen where
                                             needed
                                             Promote messages in
                                             nurseries and
                                             children centres.




                                                                                                                                                         49
                                                        Health Visiting Health Education Programme
                                                                         MATERNAL NUTRITION

    VISIT        ASSESSMENT                    ADVICE             DELIVERED                  WHERE          TRAINING           NATIONAL/PCT                 RESOURCES
                                                                      BY                                     NEEDS               TARGETS
Pre                                       Recommend folic        Midwife             Home                Training needed to   Supplement folic acid    FSA „Eating While you are
Conception   Identify:                    acid supplement        Midwife Assistant   Clinic              ensure consistency   for the first 12 weeks   Pregnant‟ leaflet
                                                   th
             -Current dietary practices   upto 12 week of        Health Visiting     Children‟s Centre   of messages          of pregnancy and pre-    5 a day resources
             -Signs of anaemia            pregnancy              and School          School              Diet and             conceptually             NHS folic acid – what all
             -Intention to breastfeed     After 12 weeks         Nursing Teams       GP                  breastfeeding        Increase                 women should know
             -Smoking habits              continue with a diet                                                                breastfeeding rates      References below
                                          rich in folic acid                                                                  by 2% per year and       Trust Obesity Policy
                                                                                                                              obesity reduction        NICE antenatal care
                                                                                                                                                       guidelines 2003
                                                                                                                                                       Dept of Health Dietary
                                                                                                                                                       Reference values for food
                                                                                                                                                       energy and nutrients in
                                                                                                                                                       the UK. Report on Health
                                                                                                                                                       and Social subjects 42.
                                                                                                                                                       London HMSO 1991
                                                                                                                                                       Dept of health – Folic acid
                                                                                                                                                       and the Prevention of
                                                                                                                                                       disease Report on Health
                                                                                                                                                       and Social Subjects 50
                                                                                                                                                       London: The Stationary
                                                                                                                                                       Office 2000
                                                                                                                                                       Food Standards agency
                                                                                                                                                       guidance
                                                                                                                                                       www.food.gov.uk
                                                                                                                                                       Food safety advice for
                                                                                                                                                       pregnancy
                                                                                                                                                       www.food.gov.uk
                                                                                                                                                       Guidelines for food and
                                                                                                                                                       health, Birmingham
                                                                                                                                                       Community Nutrition and
                                                                                                                                                       dietetic services (2006
Ante Natal                                Diet rich in folic     Midwifery team      Home                Training needed to   Supplement folic acid    Guidelines for Food and
                                          acid                   Health Visiting     Clinic              ensure consistency   for the first 12 weeks   Health Birmingham
                                          Eat a good variety     team                GP                  of messages          of pregnancy and pre-    Community Nutrient
                                          of foods daily to                          Children‟s Centre   Diet and             conceptually             Dietetic Services (2000)
                                          include; 5 portions                                            breastfeeding        Increase                 Food safety advice for
                                          fruit and                                                                           breastfeeding rates      pregnancy
                                          vegetables, 2-3                                                                     by 2% per year and       www.food.gov.uk
                                          portions protein                                                                    obesity reduction        Guidelines for food and
                                          foods, plenty of                                                                                             health, Birmingham
                                          starchy foods,                                                                                               Community Nutrition and
                                          preferably                                                                                                   dietetic services (2006)

                                                                                                                                                                               50
                                                          Health Visiting Health Education Programme
                                            wholegrain                                                                           NICE antenatal care
                                                                                                                                 guidelines 2003
                                                                                                                                 Dept of Health Dietary
                                                                                                                                 Reference values for food
                                                                                                                                 energy and nutrients in
                                                                                                                                 the UK. Report on Health
                                                                                                                                 and Social subjects 42.
                                                                                                                                 London HMSO 1991
                                                                                                                                 Dept of health – Folic acid
                                                                                                                                 and the Prevention of
                                                                                                                                 disease Report on Health
                                                                                                                                 and Social Subjects 50
                                                                                                                                 London: The Stationary
                                                                                                                                 Office 2000
                                                                                                                                 Food Standards agency
                                                                                                                                 guidance
                                                                                                                                 www.food.gov.uk

Primary Visit   Identify                    If breastfeeding see    Midwifery team    Home (Primary)      Reduction of obesity   Eating for breastfeeding
                -Current dietary practice   weaning advice          Health Visiting   Then                Increase               DH
and onwards
                -Signs of anaemia           page. No more           team              Home                breastfeeding rates    Guidelines for Food and
                -Smoking habits if          than two units of                         Clinic              by 2%                  Health Birmingham
                  breastfeeding             alcohol per day                           Children‟s Centre                          Community Nutrition and
                                            Eat a good variety                        GP                                         Dietetic Service (2006)
                                            of foods daily to                         School
                                            include five
                                            portions of fruit and
                                            vegetables




                                                                                                                                                         51
                                                              Health Visiting Health Education Programme
                                                                                         OBESITY
    VISIT            ASSESSMENT                     ADVICE                 DELIVERED          WHERE   TRAINING   NATIONAL/PCT        RESOURCES
                                                                               BY                      NEEDS       TARGET
Ante Natal      Mother overweight?            May have to advise        Health Visitor     Home                                 3 day UNICEF Breast-
                Other adults overweight?      all family members,                                                               feeding Course
                Existing children             depending on the                                                                  Dietary knowledge
                overweight?                   assessment                                                                        Obesity predictors
                Eating habits?                Dietary advice                                                                    Family support
                Drinking habits?              Shopping advice                                                                   Quit smoking BIT
                Quality of diet?              Eating habit advice                                                               Training
                Desire to breastfeed?         Breastfeeding advice                                                              Family/group support re:
                Cooking abilities?            Quit smoking – brief                                                              changing life style habits
                Cooking facilities?           intervention
                Foetus small for dates?
                Pregnancy developing          N.B Foetal life
                normally?                     influences later life –
                Ability of mother/family to   ante natal diet very
                follow advice without         important
                support?                      Target parents with
                Smokers in the family?        low cognitive abilities
                Mental/emotional health of    Low income is a
                mother?                       predictor of obesity
                                              Depression holds
                                              forward risk of
                                              obesity
Primary Visit   Baby born at term?            Dietary advice for        Health Visitor     Home                                 Bottle/artificial feeding
                Method of feeding?            mother:                                                                           and as above
                Maternal diet?                Breastfeeding/bottle
                Family diet?                  feeding advice
                In need of extra support      N.B Rapid weight
                Mental/emotional of           gain in first year is a
                mother                        predictor of obesity
                                              Rapid catch up over
                                              first 2 years for
                                              „small for dates‟
                                              babies is a predictor
                                              of obesity




                                                                                                                                                            52
                                                          Health Visiting Health Education Programme
                                                                                     OBESITY
3/4/5 months   Monitor weight gain        Feeding advice            Health Visitor     Clinic          Weaning and as above
contact        Monitor speed of weight    Adult dietary advice      Nursery Nurse      GP
               gain                       Anticipatory weaning      Practice Nurse     Surgery
               Monitor feeding            advice
               patterns                   NB Rapid weight
               Weaning progress?          gain in first year is a
                Adults in need of extra   predictor of obesity
                support?                  Rapid catch up over
                Mental/emotional          first 2 years for
                health of mother          „small for dates‟
                                          babies is a predictor
                                          of obesity
6–9 month      Monitor weight gain        Feeding advice            As above           Clinic          Diet – Adult and toddler
contact        Monitor speed of weight    Adult dietary advice
               gain                       NB Rapid weight
               Monitor feeding            gain in first year is a
               patterns                   predictor of obesity
               Weaning progress?          Rapid catch up over
               Adults in need of extra    first 2 years for
               support?                   „small for dates‟
               Mental/emotional health    babies is a predictor
               of mother                  of obesity
24–27 months   Monitor weight gain        Feeding advice            Health Visitor     Clinic          Diet adult and toddler
contact        Monitor speed of weight    Adult dietary advice      Nursery Nurse      Nursery         Sleep clinics
               gain                       NB Rapid catch up
               Monitor feeding            over first 2 years for
               patterns                   „small for dates‟
               Monitor quality of adult   babies is a predictor
               diet                       of obesity
               Monitor quality of         Less than 10 hours
               toddler‟s diet             sleep per night for
               Adults in need of extra    toddlers under 3
               support?                   years of age is a
               Sleep pattern?             predictor of obesity
               Television viewing
               hours?
               Mental/emotional health
               of mother




                                                                                                                                53
                                                           Health Visiting Health Education Programme
                                                                                     OBESITY
3–4 years   Monitor weight gain             Feeding advice          Health Visitor     Clinic           Diet adult and toddler
contact     Monitor speed of weight         Adult dietary advice    Nursery Nurse      Nursery          Parenting
            gain                            NB Watching 8
            Monitor feeding patterns        hours of television
            Monitor quality of adult diet   per week at 3 years
            Monitor quality of toddler‟s    of age is a predictor
            diet                            of obesity
            Adults in need of extra
            support?
            Sleep pattern?
            Television viewing hours?
            Mental/emotional health of
            mother




                                                                                                                                 54
                                                        Health Visiting Health Education Programme

                                                                               ORAL HEALTH

                              “Dental disease is still the number 1 disease affecting children, occurring 5 to 8 times more frequently than asthma.
                       ….We have seen unprecedented improvements in child oral health but more needs to be done to tackle this easily treatable disease”
                                                                 {Prof. Raman Bedi, Chief Dental Officer – 2005}

    VISIT            ASSESSMENT                  ADVICE              DELIVERED                  WHERE                TRAINING          NATIONAL/PCT           RESOURCES
                                                                         BY                                           NEEDS              TARGET
Ante Natal      Asses maternal diet        Is Mum registered      Health Visitor         Home                   Oral health training                       Directory of local
                Assess dietary intake/     with dentist?                                                        Procedure for                              dentists
                knowledge                  Advise Mum of her                                                    entitlement to free
                                           entitlement to free                                                  dental care
                                           dental care
                                           Dietary advice/
                                           provide information
                                            re: hidden sugars
Primary Visit   Assess maternal diet       Reinforce dietary      Health Visitor         Home
                Assess dietary intake/     advice
                knowledge                  Emphasise
                                           importance of not
                                           adding sugars/juice
                                           to water or food to
                                           bottles
6 weeks         Assess maternal diet       Reinforce dietary      Health Visitor         Clinic
contact         Assess dietary intake/     advice                 Sure Start             GP premises
                knowledge                  Emphasise              Children‟s Centres
                                           importance of no
                                           adding sugars/juice
                                           to water or food to
                                           bottles
3/4/5 months    Assess maternal diet       Reinforce              Health Visiting team   Well Baby Clinic       Oral health
contact         Assess dietary             importance of not      Sure Start             Children‟s Centres
                intake/knowledge           adding sugars/juices   Children‟s Centres     Local Stay and Play
                If weaning, assess diet    to water or food to                           Parenting Groups {if
                given to baby              bottles                                       supported by HV
                                                                                         team}




                                                                                                                                                                                55
                                                                      Health Visiting Health Education Programme
                                                                                                       ORAL HEALTH
6-9 months     Assess maternal diet                 „Bottle to cup‟ –                 Health Visiting team             Well Baby Clinic                   Necessary update of                                       „Doidy cups‟ and
contact        Assess dietary intake/               introducing use of                Sure Start                       Children‟s Centres                current oral health                                        other suitable
               knowledge                            suitable cup from 6               Children‟s Centres               Stay and Play                     messages                                                   cups/written
               Assess baby‟s dietary                months old                                                         /Parenting Groups {if              „Give it up for the                                       information
               intake                               Introduction of                                                    supported by Health                cup‟ training for HVs                                     „Give it up for the
               Assess if brushing baby‟s            cleaning baby‟s teeth                                              Visiting Teams}                    and support workers                                       cup‟ leaflets
               teeth regularly                      – correct brushing                                                 Clinic {appointed                                                                            Demonstration
                                                    technique                                                          development check}                                                                           teeth/ brush
                                                                                                                                                                                                                    „Hidden Sugar‟
                                                                                                                                                                                                                    resource box
                                                                                                                                                                                                                    {foods and bagged
                                                                                                                                                                                                                    sugar} as supplied
                                                                                                                                                                                                                    by Under 5
                                                                                                                                                                                                                    Programme
24–27 months   Asses child and maternal             Reinforce importance              Health Visiting team             „Toddler Parties‟                                                                            Directory of local
contact        diet                                 of registering with               Sure Start                       Well Baby Clinic                                                                             Dentists
               Assess whether brushing              dentist                           Children‟s Centres               Children‟s Centres                                                                           Demonstrate teeth
               child‟s teeth regularly              Reinforce correct                                                  Stay and Play                                                                                and brush
               Asses if child has bottle/           brushing techniques                                                Parenting Groups {if                                                                         Healthy eating,
               cup                                  Dietary advice                                                     supported by Health                                                                          tasting sessions
               Ask if child has visited             Reinforce „give it up                                              Visiting team}                                                                               Literacy packs
               dentist                              for the cup‟                                                                                                                                                    {„Going to the
                                                    messages                                                                                                                                                        Dentist‟}
                                                    Oral health messages
                                                    presented through
                                                    literacy schemes eg
                                                    literacy packs
                                                    supplied by Under 5s
                                                    Programme
3–4 years      Asses child and maternal             Demonstrate and                   Health Visiting team             Well Baby Clinic                                                                             Directory of local
contact        diet                                 encourage correct                 Sure Start                       Children‟s Centres                                                                           dentists
               Assess whether brushing              brushing techniques               Children‟s Centres               Stay and Play                                                                                Demonstrate teeth
               child‟s teeth regularly              Dietary advice –                                                   Parenting Groups {if                                                                         brush
               Assess if child has bottle/          „health eating‟                                                    supported by Health                                                                          „Healthy eating‟
               cup                                  Use of literacy                                                    Visiting team}                                                                               tasting sessions
               Ask if child has visited             schemes eg literacy                                                Playgroups                                                                                    Food” feely
               dentist                              packs as supplied by                                               Nursery                                                                                         bags {supplied
                                                    Under 5s programme                                                                                                                                                 by Under 5‟s
                                                                                                                                                                                                                       Programme}
                                                                                                                                                                                                                     Literacy Packs
                                                                                                                                                                                                                       {“Going to the
                                                                                                                                                                                                                       Dentist”}

                           The DOH & MAFF recommend that infants should be introduced to drinking from a cup from 6 months of age, and the use of a bottle should be actively discouraged after the age of 1 year
                                                           {COMA Report 45 – Weaning and the Weaning Diet l994} {MAFF – Healthy diets for infants & young children l997}


                                                                                                                                                                                                                                          56
                                                          Health Visiting Health Education Programme
                                                                            PARENTAL SUPPORT
    VISIT           ASSESSMENT                     ADVICE               DELIVERED                    WHERE             TRAINING             NATIONAL/PCT           RESOURCES
                                                                            BY                                          NEEDS                 TARGET
Ante Natal      Women‟s health               Diet                    Midwife                Home                   Breastfeeding           PCT target to         Birth to 5 NHS-Health
                Parental expectations of     Coping strategies       Health Visiting team   Clinic                 Ante natal depression   improve               Education Authority
                self and baby behaviour eg   Support available                                                     training                breastfeeding rates   2001
                crying and sleeping          Breastfeeding                                                         Smoking cessation       HoBtPCT Local         PCHR
                Social circumstances         promotion                                                             training                Delivery Plan 2005-   Best Buddies
                                             Smoking cessation                                                                             2008 PCT NSF for      UNICEF b‟feeding
                                                                                                                                           children              Training
                                                                                                                                                                 Smoking brief inter-
                                                                                                                                                                 vention training
Primary Visit   Parental health and social   Diet                    Health Visiting team   Home                   Management of post      Choosing Health       Getting the Right
                circumstances                Coping strategies                                                     natal depression        Every Child Matters   Start
                Health and welfare of baby   Support available                                                     training                Safeguarding          The National Service
                Feeding, handling,           Breastfeeding                                                         Stress management       Children              Framework for
                interaction                  promotion                                                             training                                      Children, Young
                Parental expectations of     Smoking cessation                                                                                                   People and Maternity
                self and baby behaviour      Advice about normal                                                                                                 services
                                             baby behaviour                                                                                                      Emerged findings
                                                                                                                                                                 DOH 2003
6-8 weeks       Parent and child             Support groups          As above               Surgery                Regular updates                               Saving Lives Our
contact         interaction                  Importance of talking                          Health Centre          In-house training                             Healthier Nation DOH
                Communication strategies     to baby                                                                                                             2001
                Feeding                      Managing sibling
                Parental expectations of     rivalry
                self and baby behaviour      Coping strategies
3/4/5 months    As above                     Support groups          As above               Home                                                                 WHO publications
contact                                      Importance of talking                          Clinic                                                               DOH Weaning Guide-
                                              to baby                                       Community facilities                                                 lines leaflet
                                             Managing sibling
                                             rivalry
                                             Coping strategies

6-9 months      Assess feeding and           Advise about mgmt of    As above               As above               Sleep management
contact         support needs of parents     feeding issues and                                                    training
                Parental expectations of     diet; sleep mgmt;
                self and baby behaviour      speech and language
                Assess parental              stimulation
                stimulation and play         Importance of
                opportunities, including     allowing safe
                safety issues                exploration of
                Assess baby sleep            environment
                behaviour                    Clear constant
                Dental health                commands
                                             Praise good – ignore
                                             bad
                                                                                                                                                                                   57
                                                     Health Visiting Health Education Programme
                                                                        PARENTAL SUPPORT
24-27 months   Assess parent/child       Use of appropriate      Health Visiting team    As above               Triple P programme
contact        interaction               children‟s services     Early years education
               Assess child behaviour    Advise about speech
               management                and language
               Safety                    stimulation
               Dental health             Importance of
               Assess parenting skills   allowing safe
                                         exploration of
                                         environment
                                         Clear consistent
                                         demands
                                         Praise good – ignore
                                         bad
3-4 years      Assess parenting skills   Advise about parental   Health visiting team    Home                   As above
contact        Management problems       example                 Play worker             Clinic
               Education facilities      Setting clear                                   Community facilities
               Dental health             consistent messages                             School
                                         and consequences
                                         around behaviour
                                         Advise about
                                         educational
                                         opportunities




                                                                                                                                     58
                                                             Health Visiting Health Education Programme
                                                                                  PHYSICAL ACTIVITY
    VISIT            ASSESSMENT                    ADVICE                 DELIVERED                    WHERE      TRAINING            NATIONAL/PCT            RESOURCES
                                                                              BY                                   NEEDS                TARGET
Ante Natal      Current activity             Local aqua natal          Midwife                Home             Training on physical   Reduce mortality    Resource file on local
                Capability                   classes                   Health Visitor         Clinic           activity               rates from CVD by   providers of exercise
                Risks                        Educate on exercise                                               Benefits               40%                 facilities
                Interests                    benefit                                                           Risks
                                             Promote walking
                                             Information to
                                             access local facilities
Primary Visit   Physical condition           Reinforce benefits of     Health Visitor         Home                                    SA Target           LA : Uptake – free
                Current levels of activity   exercise –                                                                               Reducing year on    exercise sessions
                                             psychological and                                                                        year obesity in     PN : Exercise leaflets
                                             physical                                                                                 children under 11
                                             Encourage pelvic
                                             floor exercises
                                             Uptake of Walk 2000
                                             routes
                                             Encourage family
                                             based activities
                                             Baby massage

6–8 weeks       Physical condition           Reinforce benefits of     Health Visiting team   Clinic
contact         Current levels of activity   exercise –
                                             psychological and
                                             physical
                                             Encourage pelvic
                                             floor exercises
                                             Uptake of Walk 2000
                                             routes
                                             Encourage family
                                             based activities
                                             Baby massage
                                             Information on
                                             Mother and Baby
                                             activities available
                                             locally
3/4/5 months    Levels of activity           Floor play                Health Visiting team   As above
contact         Psychological well being
                Physical well being




                                                                                                                                                                                   59
                                                     Health Visiting Health Education Programme
                                                                        PHYSICAL ACTIVITY
6–9 months   General health            Swimming classes       Health Visiting Team   Clinic
contact      Physical activity         Local „Park Walk
             Safety                    2000‟
                                       Encourage floor play

24-27        Safety                    Local Mother and       Health Visiting Team   Clinic
months       Activities                Toddler groups
contact      Physical and mental       Family activities
             wellbeing                 Parks
                                       Dance classes for
                                       toddlers
                                       As above for 9
                                       months

3-4 years    Safety                    Walk to                Health Visiting Team   Clinic
contact      Favourite activities      nursery/shops/                                Nursery
             Current activity levels   school
                                       Limited hours per
                                       week {TV}
                                       Encourage outdoor
                                       games
                                       A list of games
                                       parents can play
                                       with their children
                                       eg „What‟s the time
                                       Mr Wolf?‟
                                       Tig
                                       Musical statues
                                       Football/ball games
                                       Catch ball




                                                                                                  60
                                                              Health Visiting Health Education Programme
                                                                              POST NATAL DEPRESSION
    VISIT             ASSESSMENT                      ADVICE                  DELIVERED                    WHERE       TRAINING         NATIONAL/PCT     RESOURCES
                                                                                  BY                                    NEEDS             TARGET
Ante Natal       Screen for high risk factors   Provide information        Health Visitor         Home             Multi-cultural                      Health Visitors
                 such as:                       on PND                     Midwife                Clinic           PND training                        PND leaflets
                  Previous history of          Offer listening visits     Mental Health Team     GP Surgery       Counselling skills                  PND Support
                      depression or PND         Liaise with Midwife/       GP                                      training                            Groups
                  Low social support           GP                                                                                                     Mental Health
                  Poor partner                 Support groups                                                                                         Teams
                     relationship               Self help strategies                                                                                   Family Support
                  Recent significant life      GP/Antidepressants                                                                                     Sure Start
                     events                     Follow up visit                                                                                        Exercise
                    Use EPDS or Sheffield                                                                                                             Self Help information
                     Screening Tool with                                                                                                               Mother and Baby
                     Midwife and GP                                                                                                                    Unit at QE Hospital
                  Review high risk                                                                                                                    {Post-natal}
                     women                                                                                                                             EPDS
Primary Visit    Assessment as above           Advice as above            Health Visitor         Home             Training needs as                   Resources as above
                 Also consider:                 PND may not present                                                above                               Emphasise benefits
                 Severe or prolonged „baby‟     this early                                                                                             of family support at
                                       
                 blues may evolve into PND      Provide information                                                                                    this visit, also
                 {1}                            and contact numbers                                                                                    benefits of rest and
                                                                                                                                                       good nutrition
6-8 weeks        Assess as above                Advice as above            Health Visitor         GP surgery       As above                            Resources as above
contact          PND often begins between       Mild PND responds          GP                     Clinic           Baby Massage                        Encourage
                 6 wks & ¾ months {2}           well to listening visits   Health Visiting team                    Training                            attendance at
                                                More severe PND            Mental Health team                                                          Mother and Baby
                                                may require specialist                                                                                 groups or Baby
                                                counselling and/or                                                                                     Massage classes
                                                antidepressants                                                                                        PND Support Group
3/4/5 months     Assess as above if face to     Advice as above            Practice Nurse         GP Surgery       As above                            Appropriate leaflets
contact          face contact                   Leaflets for Practice      Health Visitor         Clinic                                               to distribute
                 Provide information/leaflets   Nurses to distribute                                                                                   Baby Massage
                 if no face to face contact                                                                                                            Classes
                                                                                                                                                       PND Support
                                                                                                                                                       Groups
6–9 months       Assess as above                Advice as above            Health Visiting team   Clinic           As above                            PND that can be
contacts         PND will most commonly         Previously diagnosed                                                                                   resolved with lst year
                 have an earlier onset than     PND may be                                                                                             will have less effects
                 6– 9 months {3}                beginning to respond                                                                                   on long term child
                                                to treatments at this                                                                                  development {4}
                                                stage




                                                                                                                                                                         61
                                                      Health Visiting Health Education Programme
                                                                     POST NATAL DEPRESSION
24–27       Persistent PND at 24-27       Refer to GP or Mental   Health Visiting team   Clinic   As above   There is evidence
months      months requires referral to   Health Team or other                                               that prolonged
contact     more specialist mental        specialist services                                                depression in
            health/counselling services   available locally                                                  Mothers adversely
                                                                                                             affects the whole
                                                                                                             family {5}
3–4 years   As for 24-27 months           As for 24-27 months                                     As above
contact




                                                                                                                                 62
                                                        Health Visiting Health Education Programme
                                                                         SMOKING CESSATION
    VISIT           ASSESSMENT                    ADVICE             DELIVERED                   WHERE       TRAINING          NATIONAL/PCT        RESOURCES
                                                                         BY                                   NEEDS              TARGET
Ante Natal      Check smoking status of     Benefits of smoking   Pregnancy Lead –        Home visit     Brief Intervention   National and PCT   Choice of leaflets
                client/family               cessation             Kathy Lee               Ante-natal     Training             targets            aimed at expectant
                CO monitoring if possible                         {07812 631677}          Clinic         „Stop‟ Smoking                          Mothers and their
                                                                                                          Training                               partners/family
                                                                                                                                                 Different languages
                                                                                                                                                 Freebies
Primary Visit   As above                    As above              Health Visitor          Home           As above              As above          Leaflets on Smoking
                                                                  Refer to „Stop‟                                                                Cessation
                                                                  Smoking Service                                                                Secondhand smoke
                                                                  {08009 179199}                                                                 Cot death
                                                                                                                                                 Freebies
6 – 8 weeks     As above                    As above              Health Visitor          GP surgery     As above             As above           Choice of leaflets
contact                                                           Support Worker          Clinic                                                 Freebies
                                                                  Practice Nurse          Home
                                                                  Sure Start/Children‟s   Pharmacy
                                                                  Centre
3/4/5 months    As above                    As above              As above                As above       As above             As above           As above
contact
6 – 9 months    As above                    As above              Health Visiting team    As above       As above             As above           As above
contact
24 – 27         As above                    As above              As above                As above       As above             As above           As above
months
contact
3 – 4 years     As above                    As above              Health Visiting team    As above       As above             As above           As above
contact                                                           Practice Nurse
                                                                  School Nurse




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                                                             Health Visiting Health Education Programme
                                                                                       VITAMIN D
    VISIT            ASSESSMENT                       ADVICE               DELIVERED                 WHERE              TRAINING         NATIONAL/PCT             RESOURCES
                                                                               BY                                        NEEDS             TARGET
Ante Natal      Diet                            Healthy eating in       Health Visiting team   Home                Healthy eating in    NSF {Children}         Vitamin D flow chart
                Prescribed and taking           pregnancy               Midwife                Clinic               pregnancy           Choosing Health        {to be written}
                Calcium and Ergocalciferol      Reinforce need for      Community Family       Children‟s Centre   Vitamin D training   White Paper
                Planned feeding method          taking                  Worker                                     UNICEF baby          Sure Start target to
                Sun exposure                    Encourage breast-                                                  friendly/Best        reduce admissions to
                                                feeding                                                             Buddies             hospital
                                                Encourage sun
                                                exposure
Primary Visit   Vitamin D status if known       Provide vitamin drops   Health Visiting team   Home                Healthy eating for   PCTs increasing        Best Buddy leaflets
                Feeding method                  Support chosen          Community Family       Clinic              breastfeeding        breastfeeding rates    and number
                Mother‟s diet                   feeding method          Worker                 Children‟s Centre                        Every Child Matters    Vitamin drop supply
                Sun exposure                    Health eating during                                                                                           Breastfeeding leaflets
                                                breastfeeding
                                                Encourage sun
                                                 exposure
6 – 8 weeks     Feeding method                  Explanation of          Health Visiting team   Home
contact         Sun exposure                     importance of          Community Family       Clinic
                                                 vitamin drops          Worker                 Children‟s Centre
                                                Encourage sun
                                                exposure
3/4/5 months    Understanding of need for       Explanation of          Health Visiting team   Home                Weaning training     WHO recommend-         Weaning leaflets
contact         continuation of vitamin         importance of           Nursery Nurse          Clinic                                   ations on breast-
                drops                           vitamin drops           Community Family       Children‟s Centre                        feeding and weaning
                Weaning, including              Weaning, including      Worker
                delaying until 6 months         delaying until 6
                Encourage sun exposure          months
                                                Encourage sun
                                                exposure
6-9 months      Understanding of need for       Explanation of          Health Visiting team   Home                Balance of good
contact         continuation of vitamin         importance of           Community Family       Clinic              health
                drops                           vitamin drops           Worker                 Children‟s Centre
                Child/family diet               Encourage vitamin
                Sun exposure                    rich foods
                                                Encourage sun
                                                exposure
24-27 months    Child/family diet               Encourage vitamin D     Health Visiting team   Clinic
contact         Sun exposure                    rich foods              Community Family       Home
                                                Encourage sun           Worker                 Children‟s Centre
                                                exposure                                       Nursery
3–4 years       Child/family diet                 Encourage vitamin    Health Visiting team   Clinic
contact         Sun exposure                         D                  Community Family       Home
                                                rich foods              Worker                 Children‟s Centre
                                                Encourage sun
                                                exposure                                                                                                                          64
                                                           Health Visiting Health Education Programme
                                                                                        VITAMIN K
    VISIT            ASSESSMENT                     ADVICE                DELIVERED                WHERE            TRAINING          NATIONAL/PCT      RESOURCES
                                                                              BY                                     NEEDS              TARGET
Ante Natal      Ascertain whether planning    Discuss benefits of      Health Visitor        Ante natal clinic   HoBtPCT Policy on   DOH 1998         Women‟s Health
                to give Vitamin K and         Vitamin K                Midwife               Home                Administration of   Vitamin K for    Information Vitamin
                method of administration –                                                   GP Practice         Vitamin K           newborn babies   K for newborns
                oral or IM                                                                                                                            {2004}



Primary Visit   Check if Vitamin K given      If given orally remind   Health Visitor        Home                As above            As above         Birth to 5 NHS –
                                                    rd
                and method of                 re: 3 dose at 4/52 if    GP                    GP Practice                                              Health Education
                administration – oral or IM   breastfed                                                                                               Authority {2001}




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                                                          Health Visiting Health Education Programme
                                                                                     WEANING
    VISIT           ASSESSMENT                   ADVICE             DELIVERED                WHERE          TRAINING           NATIONAL/PCT                RESOURCES
                                                                        BY                                   NEEDS               TARGETS
Ante Natal                                                         Midwife           Home                Training needed to   Supplement Folic        FSA „Eating While you are
                                                                   Midwifery         Clinic              ensure consistency   Acid for the first 12   Pregnant‟ leaflet
                                                                   Assistant         Children‟s Centre   of messages          weeks of pregnancy      5 A day resources.
                                                                   Health Visiting                       Diet and             and pre-conceptually    NHS Folic Acid – What all
                                                                   Team                                  breastfeeding        Increase breast-        women should know
                                                                                                                              feeding rates by 2%     References below
                                                                                                                              per year and obesity    Trust Obesity Policy
                                                                                                                              reduction



Primary Visit   Feeding method              Mother‟s health:       Health Visitor    Home                Diet and             Increase                FSA „Eating for
                Sterilising method used     If breastfeeding       Midwife                               breastfeeding        breastfeeding rates     Breastfeeding‟ leaflet
                for equipment               check diet and fluid                                         Signs of anaemia     by 2% per year          Department of Health
                Correct method of formula   intake adequate                                              Up to date re                                Dietary Reference values
                reconstitution              Look for signs of                                            Healthy Start/                               for food energy & nutrients
                                            anaemia – prompt                                             Welfare Foods                                in the UK Report on
                                            to visit GP                                                                                               Health & Social subjects
                                            Baby‟s health: If                                                                                         42. London: HMSO 1991
                                            breastfeeding                                                                                             Birmingham Community
                                            ensure mother                                                                                             Nutrition & Dietetic
                                            taking vitamin D                                                                                          Service „Guidelines for
                                            supplement                                                                                                Food & Health‟ – Under
                                            Check frequency of                                                                                        5s & Maternal Health
                                            feeding including                                                                                         sections
                                            overnight feeds and                                                                                       DoH statement on
                                            positioning                                                                                               Formula Preparation
                                            Ask if Mum             Health Visitor
                                            requires more
                                            support to establish
                                            breastfeeding (Best
                                            Buddies)
                                            Check Mum is
                                            making formula
                                            feeds up correctly
                                            (see Birmingham
                                            Community
                                            Nutrition and
                                            Dietetic Service
                                            „Guidelines for
                                            Food & Health‟
                                            Under 5s section
                                            and DoH statement
                                            on formula
                                                                                                                                                                             66
                                                      Health Visiting Health Education Programme
                                        Preparation (1) and
                                        that bottles are
                                        being sterilised
                                        correctly
                                         Check mother
                                        knows about
                                        Welfare Food
                                        Scheme/Healthy
                                        Start and is
                                        claiming if eligible
6-8 weeks   Feeding method              Mother‟s health:       Health visitor   GP              Infant nutrition   Increase breast   BMI should be on
contact     Sterilising method used     If BMI >30 or <18      GP               Health Centre   updates            feeding rates     mother‟s post natal notes
            for equipment               check been offered                                                         by 2% year        (coming out soon)
            Correct method of formula   dietetic input via                                                                           If BMI abnormal may
            reconstitution (1)          GP                                                                                           affect subsequent
                                        (NB weight                                                                                   pregnancy.
                                        reducing diet not                                                                            (CEMACH Report „Why
                                        recommended if                                                                               Mothers Die‟ 2004[for
                                        breastfeeding)                                                                               obesity];
                                        Check frequency of                                                                           Bull,J;Mulvihill, C &
                                        feeding including                                                                            Quigley R, 2003.
                                        overnight feeds and                                                                          Prevention of low birth
                                        positioning.                                                                                 weight: assessing the
                                        Ask if Mum                                                                                   effectiveness of smoking
                                        requires more                                                                                cessation and nutrition
                                        support to establish                                                                         interventions. Evidence
                                        breastfeeding (Best                                                                          briefing. London: Health
                                        Buddies)                                                                                     Development Agency [for
                                        Check Mum is                                                                                 low BMI]
                                        making formula                                                                               Birmingham Community
                                        feeds up correctly                                                                           Nutrition & Dietetic
                                        (see Birmingham                                                                              Service „Guidelines for
                                        Community                                                                                    Food & Health (3) – Under
                                        Nutrition and                                                                                5s and Maternal Health
                                        Dietetic Service                                                                             sections
                                        „Guidelines for
                                        Food & Health‟ (3)
                                        – Under 5s section
                                        and DoH statement
                                        on Formula
                                        Preparation (1) and
                                        that bottles are
                                        being sterilised
                                        correctly




                                                                                                                                                           67
                                                            Health Visiting Health Education Programme
               Preparation for Weaning        Discuss weaning         Health Visitor   Home                Weaning
               (Introduction of Solids) (2)   and encourage           assistant        Telephone           Training
                                              parents to              Community
                                              exclusively breast      Family Worker
                                              of formula feed until   Health visitor
                                              infant is 6 months
                                              old (no earlier than
                                              17 weeks)(2)
3/4/5 months                                  3 month contact:                                             Training to ensure                            FSA Thinking of having a
contact                                       Planning next                                                consistency of                                baby leaflet.
                                              pregnancy:                                                   method.                                       NHS Folic acid – What all
                                              Folic acid                                                                                                 women should know
                                              supplement pre-                                                                                            leaflet
                                              conceptually                                                                                               Department of Health.
                                              If mother diabetic                                                                                         Folic acid & the
                                              (type 1 or type 2)                                                                                         Prevention of Disease.
                                              prompting to attend                                                                                        Report on Health & Social
                                              pre-conceptual                                                                                             Subjects 50.London: The
                                              diabetes care                                                                                              Stationary office 2000.
               Preparation for Weaning        Discuss Weaning         Health Visitor   Home                Weaning              Sure Start target;       Pregnancy in Women with
               (Introduction of Solids) (2)   and encourage           assistant        Telephone           Training             reduce the number of     Type 1 & Type 2 diabetes.
                                              parents to              Community        Weaning Talk in                          infants admitted to      2002-2003 CEMACH
                                              exclusively breast      Family Worker    Community Setting                        hospital with            Report
                                              or formula feed         Health visitor                                            gastroenteritis and      Birmingham Community
                                              until infant is 6       Practice Nurse                                            respiratory infections   Nutrition and Dietetic
                                              months old (no          Link Worker                                               by 10%                   Service “Guidelines for
                                              earlier than 17                                                                                            Food & Health”(3) – Under
                                              weeks)(2)                                                                                                  5s & Maternal Health
                                              If weaning                                                                                                 sections
                                              commenced –                                                                                                Birmingham Community
                                              advice on                                                                                                  Nutrition & dietetic Service
                                              appropriate                                                                                                „Weaning Photos
                                              textures encourage                                                                                         Resource‟
                                              homemade foods                                                                                             Department of Health
                                              and avoidance of                                                                                           „Weaning‟ leaflet
                                              significant
                                              allergenic foods
6 9 months     Weaning progress               Advise on suitable      Health Visitor   Home                Weaning                                       Birmingham Community
contact                                       foods at different      assistant        Telephone           training                                      Nutrition and Dietetic
                                              ages                    Community        Weaning Talk in     Bottle to cup                                 Service „Guidelines for
                                              Reinforce               Family Worker    community setting   training                                      Food and Health‟ (3) –
                                              messages about          Health visitor                                                                     Under 5s and Maternal
                                              avoiding salt           Link Worker                                                                        Health sections
                                              Encourage to move       Nursery Nurse                                                                      Bottle to Cup leaflets
                                              textures on to                                                                                             Birmingham
                                              prevent food                                                                                               Community Nutrition and
                                              refusal later                                                                                              dietetic Service „Weaning

                                                                                                                                                                                 68
                                                   Health Visiting Health Education Programme
                                    Check foods                                                           Photos Resource
                                    offered provide                                                       Department of Health
                                    variety including                                                     „Weaning‟ leaflet
                                    fruit and vegetables                                                  Trust Information leaflet
                                    Encourage suitable                                                    for 3-4 months contact
                                    drinks and drinking
                                    cups or beakers to
                                    promote good
                                    dental health
                                    Prepare for dietary
                                    changes at 1 year
                                    old eg moving onto
                                    cows milk as main
                                    drink
                                    Encourage vitamin
                                    drops (available on
                                    Welfare Foods
                                    scheme for those
                                    on benefits)
24-27 months   Dietary Intake and   Advise on 5 food        Health Visitor   Clinic      Healthy Eating   Birmingham Community
contact        anaemia              groups in Balance       assistant        Telephone   Training         Nutrition and Dietetic
                                    of Good Health          Community                    Bottle to cup    Service “Guidelines for
                                    especially checking     Family Worker                training         Food & Health” (3) –
                                    for good sources of     Health visitor                                Under 5s section.
                                    Iron in diet.           Link Worker
                                    Encourage 5             Nursery Nurse                                 FSA booklet „Feeding your
                                    portions of fruit and                                                 toddler”
                                    vegetables each                                                       Bottle to Cup leaflets
                                    day                                                                   CAMHS team booklets on
                                    Check cow‟s milk                                                      behaviour
                                    as a drink intake                                                     Management available
                                    not more than                                                         FREE
                                    500ml daily
                                    Reinforce Dental
                                    Health Message
                                    with respect to
                                    types of drinks and
                                    cups
                                    Encourage family
                                    meals
                                    Ask about textures
                                    of foods eaten –
                                    encourage varied
                                    textures and range
                                    of foods



                                                                                                                                  69
                                                     Health Visiting Health Education Programme
                                      Discuss general
                                      behaviour
                                      management
                                      including mealtime
                                      management
3–4 years   General diet and growth   Advise on 5 food        Health Visitor   Clinic               Healthy Eating   Birmingham Community
contact                               groups in Balance       assistant        Telephone            Training         Nutrition and Dietetic
                                      of Good Health          Community        Pre-School setting   Bottle to cup    Service „Guidelines for
                                      especially checking     Family Worker    Centre               training         Food and Health‟ (3)–
                                      for good sources of     Health Visitor                                         Under 5s section.
                                      Iron and calcium in     Nursery Nurse                                          FSA booklet; Feeding
                                      diet.                   Link Worker                                            your growing child
                                      Encourage 5             School Nurse                                           Bottle to cup leaflets
                                      portions of fruit and
                                      vegetables each
                                      day




                                                                                                                                           70
                       Health Visiting Health Education Programme



APPENDIX 5 SCHOOL NURSING HEALTH PROMOTION
           PROGRAMME


   Handwashing
   Dental Hygiene
   Reception Parent Drop Ins
   Year 3 Roadshow
   Puberty
   Transition
   Smoking drama
   Sex education




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                                       Health Visiting Health Education Programme

                                   SCHOOL NURSE HEALTH EDUCATION PROGRAMME
                                      ALL SESSION WILL TAKE PLACE IN SCHOOL

   Programme Topic             Aim of Session          Delivered by   Training Needs       National and PCT        Resources
                                                                                                 targets
Handwashing               To promote the importance School Nurse      How to use a      Infection control     Lightbox
(Reception class)         of handwashing to prevent Assistants        light box                               Handwashing lotion
                          cross infection and address                 Basic delivery
                          infection control                           skills

Dental Hygiene            To promote the importance    School Nurse   Basic delivery    Reduce incidence of
                          of good dental hygiene and   Assistants     skills            dental caries
                          reduce the incidence of
                          dental caries
Reception Parental Drop   To address health issues     School Nurses Launch of          Access to services/
Ins                       and raise awareness of                     programme          signposting
                          public health issues                                          Obesity
                                                                                        Exercise
                                                                                        Smoking
                                                                                        Mental health
Year 3 Roadshow           To raise awareness of the    Corporate      Rehearsal time    NSF                   Display boards
                          effects of smoking, diet and teams                            Smoking               Pictures of healthy
                          exercise in relation to                                       Obesity               food
                          coronary heart disease                                        Exercise

Puberty                   To raise awareness of        School Nurses Training for new   Every child matters   Selection of sanitary
                          body changes at puberty                    staff and          NSF                   wear
                          and to give information                    updates
                          about menstruation
                                          Health Visiting Health Education Programme


    Programme topic   Aim of session                   Delivered by   Training needs       National and PCT          Resources
                                                                                                targets

Transition            To prepare children              School Nurses Training for new    Improve mental
                      emotionally for the transition                 staff and           resilience and mental
                      from primary to secondary                      updates             health
                      school and to give children
                      strategies to cope with this
                      transition
Smoking drama         To raise awareness of the        School Nurse   Training for all   Smoking
                      dangers of smoking and to        Team           staff
                      give children skills to say no
                      to smoking
Sex education         To raise awareness of and        School Nurses Training for new    Every child matters     Condoms and
                      give accurate information                      staff and           NSF                     condom
                      about:                                         updates             Reduce teenage          demonstrators
                       Sexually transmitted                                             pregnancies             Contraception
                          infections                                                     Reduce sexually         resource pack
                       Contraception                                                    transmitted infection   Models of breasts
                       Relationships                                                    rates                   and testicles
                       Breast/testicular
                          awareness




                                                                                                                                     73
                         Health Visiting Health Education Programme



APPENDIX 6             CULTURAL COMPETENCE

The population we serve requires us to be culturally competent, in order to deliver effective services.

It is essential that all practitioners and team members are clinically up to date and give evidence based
effective practice. This is a two-way process and practitioners should be pro-active in accessing
information needed to enhance their practice and skills.

In order to support Practitioners in doing this the Trust has:

      Mandatory Cultural Competence Training

      The following members of the Nursing Team

      Gwen Gerald – Nurse Education and Development Manager
      Angela Knight Jackson - Nursing Support for Research and Development

      The Nursing Directorate

      Health Visiting Clinical Lead - Gemma Mngaza
      School Health Clinical Lead – Janet Savage
      The Modern Matrons - Doreen Bennett, Pam Beswick, Mary Rutledge, Tracey Sheridan,
       Chris Wint




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Health Visiting Health Education Programme

								
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