HEALTH SCREENING
HEALTH SCREENING
MINDFULL MINUTE
Box Breathing
Box breathing is a mindfulness technique that helps to promote relaxation. It is similar to the 4-7-8 breathing technique but is shorter and incorporates visualization to aid the process.
Steps to Perform Box Breathing:
Visualize the left side of a two-dimensional square.
Inhale to the count of 4 while imagining moving to the top of the square.
Hold your breath for 4 seconds, envisioning yourself moving towards the right side of the square.
Exhale for 4 seconds while imagining going down the right side of the box.
Hold for another 4 seconds at the bottom of the box.
Repeat the process, doing a maximum of four rounds in one minute.
KARAKIA
A traditional Māori invocation or prayer used to honor the presentation of ideas and promote well-being:
Tuutawa mai i runga
Tuutawa mai i raro
Tuutawa mai i roto
Tuutawa mai i waho
Kia tau ai te mauri tuu
Te mauri ora
Ki te katoa
Haumi ee! Hui ee! Taiki ee!
Translation:
"Come forth from above, below, within, and from the environment. Vitality and wellbeing for all, strengthened in unity."
LEARNING OUTCOMES
Understand the concept and purpose of health screening.
Learn about the benefits and risks associated with screening.
Differentiate between organized and opportunistic screening.
Discuss the implications of positive and negative screening results.
Explore various types of screenings and their significance in public health.
WHAT WILL BE COVERED
Purpose of Health Screening
Health screening identifies individuals at risk for health conditions, enabling early intervention that leads to improved health outcomes.
Screening Methods
Understanding the differences between organized and opportunistic screening methods can highlight their respective benefits and potential risks.
Importance in Public Health
Health screening is a crucial component of public health, as it plays a vital role in disease prevention and management, promoting overall health in the community.
Application to Practice
Discussion on effectively applying health screening concepts in nursing and healthcare practice.
WHY SCREEN?
Purpose of Health Screening:
Screening helps identify individuals at risk before any symptoms appear, which is essential for timely health risk detection.
Early detection through screening leads to timely interventions and better health outcomes.
Reassurance:
Many participate in screening with the hope of reassurance regarding their health status, rather than anticipating that they may be diagnosed with a condition.
Important note: Screening does not provide a definitive diagnosis; it merely indicates risk levels.
BENEFITS OF SCREENING
Potential Benefits:
Screening programs can detect various conditions early, significantly reducing the risk of developing severe complications or mortality from conditions such as certain cancers.
Screening reduces overall healthcare costs and disease burden by enabling preventive care and fostering better prognoses.
Screening allows for early identification and treatment of diseases such as breast and cervical cancer before any symptoms manifest.
In newborns, screening can identify conditions that are treatable before preventable disabilities arise.
SOME EXAMPLES OF SCREENING IMPACT
Breast Screening:
Reduces mortality risk from breast cancer by approximately 30% for women aged 50-65 and by about 45% for women aged 65-69.
Cervical Screening:
Decreases the likelihood of developing cervical cancer by around 90%.
Newborn Hearing Screening:
Facilitates early detection of hearing loss, allowing for timely help including resources, parental support groups, hearing aids, cochlear implants, and early introduction to sign language.
ARE THERE ANY RISKS?
Risks Associated with Screening:
Screening tests may present risks of yielding false results:
False-Negative Result:
Occurs when an individual who has the condition is incorrectly deemed part of a low-risk group.
Can provide misplaced reassurance and delay necessary intervention and treatment.
False-Positive Result:
Happens when a person without the condition is categorized as having an increased chance of having it.
May lead to unnecessary anxiety and further diagnostic testing.
NURSING ROLE IN SCREENING
Educational Role of Nurses:
Nurses are crucial in educating and motivating patients to engage in screening programs, enhancing overall health benefits.
Facilitation Duties:
Nurses facilitate necessary health assessments for screening purposes.
Informed Consent:
Nurses must clearly communicate the risks of screening tests to patients to ensure informed consent and support patient decision-making processes.
Effective screening requires balancing the benefits against potential risks while managing patient expectations.
NATIONAL SCREENING UNIT
The National Screening Unit oversees the quality and equity of screening programs, ensuring adherence to evidence-based practices.
Scope and Focus:
Implements large-scale screening initiatives to guarantee health benefits across populations, emphasizing coordination and monitoring.
Types of Programs Offered:
Breast, cervical, bowel, and newborn screenings are included, each with established criteria and follow-up procedures.
Ensures high standards in organized screening programs, with external evaluations monitoring service quality and consistency – providing uniform services, information, and support to all participants.
NATIONAL HEALTH COMMITTEE AND SCREENING
The National Health Committee authored criteria for evaluating potential new screening programs:
Condition Suitability: The health condition must be appropriate for screening.
Suitable Tests: There needs to be a reliable and effective test available.
Effective Treatments: An accessible and successful treatment or intervention should exist for identified conditions.
Evidence of Effectiveness: High-quality evidence demonstrating the screening program's impact on reducing morbidity and mortality is essential.
Benefit-Harm Balance: There should be a clear advantage of test benefits over any potential harms.
Support Capacity: The healthcare sector must be equipped to handle diagnosis, follow-ups, and program evaluations.
Social and Ethical Considerations: Must address social and ethical dilemmas pertaining to the screening.
Cost-Benefit Issues: An assessment of costs in relation to expected health benefits must be included.
HEALTH EQUITY FOCUS
Programs strive to ameliorate health inequities and enhance outcomes for specific populations including Māori, Pacific peoples, and marginalized communities.
Advisory Groups:
Engage committees like the National Screening Advisory Committee and the Māori Monitoring and Equity Group.
Cultural Alignment:
Align practices with Te Tiriti o Waitangi while working collaboratively with Māori communities to ensure culturally safe, family-centered care.
Targeted Outreach Efforts:
Identify and reach out to under-screened demographics using community navigators and improved contact approaches.
Culturally Appropriate Communication:
Provide educational materials in various languages and formats; tailor messages catering to Māori, Pacific, migrant, and refugee communities.
Accessible Services:
Offer mobile clinics, convenience with scheduling, transport assistance, and self-testing options to mitigate barriers faced by rural and low-income populations.
Workforce Development:
Train healthcare professionals in cultural competence and awareness of biases; recruit a diverse health workforce to foster trust in healthcare delivery.
2 TYPES OF SCREENING
Organized Screening:
Regularly scheduled tests, often mandated by health authorities for populations at risk.
Opportunistic Screening:
Screening provided during healthcare visits or initiated by health professionals due to patient requests or concerns.
2 GROUPS OF SCREENING RESULTS
Positive Screening Result
Indicates an increased likelihood of a condition; requires additional diagnostic testing for confirmation.
Negative Screening Result
Suggests a reduced likelihood of a condition; no immediate follow-up is necessary but may warrant future screenings.
WHAT NEXT?
Post-Screening Actions:
Individuals with a positive result will be referred for diagnostic testing to determine if a condition is present.
Those with a negative result typically won’t receive immediate follow-up testing but may be invited back for subsequent screenings.
Nurses should leverage screening outcomes to optimize communication, provide follow-up care, and support emotional well-being for patients.
Accurate screening methodologies and clear procedural guidelines are critical for managing patient safety and effective healthcare.
ORGANISED SCREENING PROGRAMMES
Individuals in New Zealand are encouraged to engage in organized screening initiatives funded based on identified high-risk population demographics.
The National Screening Unit manages and supervises nationwide organized screening initiatives:
Antenatal Screening: Includes evaluations for conditions such as Down syndrome and HIV during pregnancy.
BreastScreen Aotearoa: Offers free mammograms biennially for women aged 45-69 who meet eligibility criteria.
National Bowel Screening Programme: Distributes biennial faecal immunochemical tests (FIT), followed by colonoscopy if results indicate risk of bowel cancer.
National Cervical Screening Programme: Utilizes HPV screening, allows self-testing, and suggests follow-ups if HPV is present.
Newborn Metabolic Screening Programme: Heel prick tests performed to identify treatable metabolic disorders in infants within the first few days of life.
Newborn Hearing Screening Programme: Conducted prior to discharge from the hospital to catch hearing issues early.
ANTENATAL SCREENING
Offered universally to all pregnant individuals in New Zealand, employing:
First trimester combined screening including blood tests and nuchal translucency ultrasound.
Second trimester maternal serum screening.
Non-Invasive Prenatal Screening (NIPS) may also be an option at the patient's expense.
HIV Screening: Part of standard prenatal care with results used to evaluate the risk of conditions like Down syndrome.
Follow-Up: Diagnostic tests, such as amniocentesis, may be offered if screening suggests elevated risk.
Participation is voluntary but strongly encouraged and is funded under the public maternity care system for eligible individuals.
BREASTSCREEN AOTEAROA
Provides free mammography every two years at various clinics, including mobile units across the country.
Targets asymptomatic women; those presenting symptoms are referred through their general practitioner.
Eligibility encompasses women aged 45-69 provided they meet public health service criteria and haven't had a mammogram in the past year.
NATIONAL BOWEL SCREENING PROGRAMME
Offers free FIT mailed biennially; positive results lead to colonoscopy procedures to detect early signs of bowel cancer or polyps.
Target demographic: individuals aged 60-74 qualifying for public health services; starting from October 2025, the starting age will decrease to 58 years.
Specific pilot projects targeting Māori and Pacific populations aged 50-74 are in progress. Equity initiatives are in place to serve underserved groups.
NATIONAL CERVICAL SCREENING PROGRAMME
Primary Test: HPV screening, with options for self-testing available.
Requires follow-up procedures such as cytology or colposcopy if HPV is detected.
Recommendations for testing every 5 years (or every 3 years for immune-deficient individuals).
Funded populations comprise a range of groups including Māori and Pacific wāhine aged 25-69, Community Service Card holders aged 25-69, and individuals aged 30+ who have never been screened.
Follow-up testing is free for all participants.
NEWBORN METABOLIC SCREENING PROGRAMME
Conducts heel prick blood tests within 24-48 hours post-birth to screen for rare but manageable metabolic and genetic disorders, such as cystic fibrosis.
Samples are processed at a central laboratory with results reported within 10 days.
This screening is available free of charge to all infants born in New Zealand, and while participation is optional, it is strongly advocated.
Residual Blood: Parents may opt to have leftover blood spots either returned or stored.
NEWBORN HEARING SCREENING PROGRAMME
Screenings are performed either before hospital discharge or at community clinics using methods such as automated auditory brainstem response (aABR) or otoacoustic emissions (OAE).
Babies failing initial screenings are referred for audiological assessments and early intervention measures.
All newborns in New Zealand are eligible for complimentary hearing screenings, with support extending through to school entry, including necessary follow-ups and amplification devices if indicated.
OPPORTUNISTIC SCREENING
Definition:
Occurs when an individual seeks advice from a healthcare professional for tests or checks, or the healthcare provider offers screening during consultations.
Common examples include prostate cancer screening and sexual health assessments.
OPPORTUNISTIC SCREENING DETAILS
Screening Type
Purpose and Rationale
Blood Pressure: Detects hypertension early, preventing stroke, heart attack, and kidney diseases.
BMI & Waist Circumference: Assesses weight status related to diabetes, heart disease, and cancers.
Cholesterol Testing: Identifies dyslipidaemia to avert cardiovascular issues and strokes.
Blood Glucose Testing: Screens for diabetes to prevent severe complications such as blindness and kidney failure.
Wellness Checks: Provides an overall health snapshot, helping to detect infections, cardiac issues, and metabolic imbalances.
WELLNESS CLINICS
Involves planned community events during Week 2 where health screening is conducted in various settings, including schools and police stations.
Typical measurements include:
Blood pressure,
Heart rate,
Respiratory rate,
Cholesterol,
Blood glucose,
Height,
Weight,
Body Mass Index (BMI),
Urinalysis (dependent on clinic specifics).
WHAT ARE WE SCREENING FOR?
Facilitators will encourage group discussions regarding the specific tests conducted at wellness clinics.
Key points to consider include:
The specific measurements each test evaluates,
Normal ranges for those measurements,
Significance of the test results to overall health.
BMI & WAIST CIRCUMFERENCE
Body Mass Index (BMI) Calculation:
Formula:
Important note: BMI should primarily serve as a guideline, as it is unsuitable for individuals under 18 years, highly muscular individuals, pregnant women, or extremes in height (less than 1.5m or more than 1.9m).
BLOOD GLUCOSE MEASUREMENT
Capillary Blood Glucose Test:
A minimally invasive test providing results within 5 seconds.
Normal adult range: 4 - 7.5 mmol/L.
Report results indicating diabetes if:
>7.5 mmol/L (fasting) or
>11 mmol/L (postprandial, after eating).
CHOLESTEROL TESTING
Cholesterol Testing:
A minimally invasive test with a results turnaround of approximately 2 minutes.
Recommended ideal adult cholesterol levels: below 4 mmol/L; report any reading over 4.5 mmol/L for potential further testing.
High cholesterol levels are linked to increased risk of cardiovascular disease.
WELLNESS CLINIC PREPARATION
CLS Session:
To be conducted the Monday prior to the wellness clinic to prepare for all assessments, ensuring participants have time to practice.
Communication Preparation:
Practice communication methods with peers, family, and self-reflection in the mirror.
Brainstorm conversation starters and consider communication techniques, alongside the therapeutic use of self in interactions.
GO TO MENTI.COM
Discussion and Quiz:
Engage with interactive discussions and quizzes related to the content covered in the session.