View
215
Download
0
Category
Preview:
Citation preview
“He’s like that because I married my cousin. It’s Tiwi way.”
Father of a Child with Global Developmental Delay and Ear Disease, Feb 2013
“We been growling him and hitting him cos we think he bein’ naughty…and
he couldn’t listen us.”Mother of a Child with Bilateral OME and Moderate Hearing Loss, Oct 2013
Increased Role for Audiology in
Primary Health
• Ear and Hearing Health Education for
Professionals
• Health Promotion and Literacy
Development to Individuals and Families
• Improved support to surveillance programs
• Extended audiological scopes of practice
Ear & Hearing Health Education to
Health and Education staff
“We didn’t refer them to the
Health Centre because they
don’t have ear disease. They
just don’t hear very well.”Special Needs Teacher, Remote Community, Central Australia, Nov 2012
Ear Health vs Hearing
• Foreign Body
• Otitis Media (OM)
– ETD
– OME
– AOMwoP
– Dry Perforation
• Otitis Externa
• Otitis Media
– AOMwiP
– CSOM
• Difficulty following
conversation in noise
• Difficulty understanding
over distance
• Requires visual cues for
understanding
• Poor attention for
auditory stimuli
• Speech language delay
• Learning challenges
A
s
y
m
pt
o
m
at
ic
S
y
m
pt
o
m
at
ic
Ear & Hearing Health Education to
Health and Education staff
• Auditory development
• Impacts of ear disease
• Signs and symptoms of ear/hearing problems
• Simple checks for ear health
• Importance of early intervention for ear/hearing problems
• Referral pathways
Ear Health Promotion and Health
Literacy Development
• To individuals and families
• Supports client decision-making
• Involves
- Identifying current health literacy level (including the
client’s personal capacity to take in and act on new
information)
- Recognising cultural and personal concepts of health
- Relating info back to the client’s own environment and
family priorities to ensure relevance
Screening vs Surveillance
• Screening
– Takes a snapshot of the
ear/hearing health at one
point in time
– Is often an isolated incident
– No evidence that screening
improves outcomes for
young children with OM
(Hopkins & Morris, 2009)
– Management of
ear/hearing is usually
based on single set of
results
• Surveillance
– Systematic gathering of ear
and hearing health of an
individual/group over time
– Screening is incorporated
in accumulated data
– Management of
ear/hearing is determined
on both individual
screening and accumulated
data
Benefits of Surveillance
Can build ear health surveillance into regular
health checks (well baby, immunisation
visits, GP visits)
Can identify children with ear health/hearing
concerns earlier than formal screening
programs => early intervention
Provides more opportunities for ear
health/hearing literacy development with
parents and carers
Interdisciplinary Collaboration• Community Authorities (Council, Elders, etc.)
– to support shared outcomes of community-based ear health/hearing programs
– to provide community/cultural knowledge
• Child Health and Early Childhood Workers – to support early ear/hearing problem identification and
management
• Education staff and Allied Health– to support remediation of impacts of hearing loss
• Health Educators/Promoters and Interpreters– to develop health literacy in client populations
• ENT Specialists – to medically manage advanced or persistent ear disease
• Researchers – to develop and evaluate effective treatment and management
methods
Extended Audiological Scopes of
Practice
Ear Canal Management
• tissue spears for discharge (anyone)
• wax removal using loupes or syringing
Diagnosis of Otitis Media Conditions
COMHeLP• Overview of OM in the A&TSI population
Includes extended audiological scopes of practice
• Section 1: Practical Considerations
Includes ear and hearing health education for professionals
• Section 2: Preventative Strategies and messages to Improve
Health Literacy
Includes health Promotion and Literacy Development to
Individuals and Families
• Section 3: Primary Surveillance, Management and Referral
Includes improved support to surveillance programs
• Section 4: Identification: Diagnostic Audiological Assessment
Includes extended audiological scopes of practice
• Section 5: Management and Rehabilitation of Hearing Loss
• Section 6: Research, Evaluation and Quality Improvement
Ongoing Challenges
• Staff turnover, especially in rural/remote =>
constant need to establish relationships and
train basic information over again
• Documentation
– access to records across different systems
– quality of documentation, especially client education
– tracking for surveillance through individual client
records
• Fatigue and frustration for families managing
Chronic OM
Recommended