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Tues NNMC PI Project VISION SCREENING. Marcia Frye Candice Snyder Katie Charnock Michael Cunningham Bridget Cunningham. AAP Policy Statement. Anatomy and gross visual assessments should be checked from birth to 3 years of age, about the age when visual acuity can be measured reliably.
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Tues NNMC PI ProjectVISION SCREENING Marcia Frye Candice Snyder Katie Charnock Michael Cunningham Bridget Cunningham
AAP Policy Statement • Anatomy and gross visual assessments should be checked from birth to 3 years of age, about the age when visual acuity can be measured reliably. • Visual acuity testing is recommended for all children startingat 3 years of age with every well visit • Vision should be assessed whenever there is a complaint about vision
Problem • Perceived low number of documented visual acuity on AHLTA chart • Chart review of 250 well visits ages 4yrs and greater • Intervention • Repeat chart review
Data Dates: 01 Jul – 04 Aug Total: 117/252 46% Excluding 4yo 114/224 51% Abnormal: 26/117 22% (12 of 26 referred) • 4yo 3/28 11% • 5yo 28/42 67% • 6yo 16/24 67% • 7yo 7/17 41% • 8yo 13/24 54% • 9yo 7/17 41% • 10yo 4/10 40% • 11yo 12/25 48% • 12yo 5/17 29% • 13yo 7/12 58% • 14yo 5/14 36% • 15yo 2/6 33% • 16yo 3/4 75% • 17yo 2/8 25% • 18yo 0/1 0% • 19yo 2/2 100%
Intervention • Questionnaire to all corpsmen working in clinic identifying obstacles • Education to all corpsmen regarding importance of test/documentation and guidelines from AAP • Increased number of charts in clinic by 300% (4 charts-Snellen and picture)
Repeat Data Dates 16 Feb – 12 Apr Total: 110/272 40% Excluding 3-4y/o 110/235 47% Abnormal: 10/110 9% (4 of 10 referred) • 3yo 0/2 0% • 4yo 0/35 0% • 5yo 17/49 35% • 6yo 13/35 37% • 7yo 12/26 46% • 8yo 12/21 57% • 9yo 10/17 59% • 10yo 8/17 47% • 11yo 9/19 47% • 12yo 9/15 60% • 13yo 3/10 30% • 14yo 3/7 43% • 15yo 5/7 71% • 16yo 3/4 75% • 17yo 2/4 50% • 18yo 2/2 100% • 21yo 2/2 100%
Hypothetical Problems/Reasons for Decline • Not performed due to optometry visit in the last year (w/o documentation of the appointment) • Vision screened but not recorded (b/c corpsman brings pt to room w/ vitals sheet) • Failure of physicians to recognize screen not performed or documented • Patients late to appointment and rushed to room • Not recognizing 3 and 4 year olds should be screened (despite training)
Future • Improve documentation • Incentive program with HMs • Personal responsibility