Health risk screening in adolescents: room for improvement in a tertiary inpatient setting.
OBJECTIVE
To determine the extent to which comprehensive health screening of adolescents was undertaken in a tertiary inpatient setting.


METHODS
Retrospective review of 100 consecutive medical records of 13-18-year-old adolescents admitted to The Royal Children's Hospital, Melbourne (first 20 consecutive admissions in 2001 to each of five units--general medicine, adolescent medicine, specialty medicine, general surgery, and specialty surgery).


METHODS
Documentation of screening for biomedical (height, weight, pubertal staging, and hepatitis B vaccination) and psychosocial concerns (HEADSS framework categorised into four screening levels--none, incomplete, adequate, thorough). Risks identified and actions taken.


RESULTS
Weight was recorded for 98 patients, height for 17, pubertal staging for 12, and hepatitis B vaccination status for nine. Documentation of psychosocial screening was absent from 62 charts, inadequate in 29, thorough in three, and complete in seven charts. Adolescent medicine inpatients were more likely than patients in other units to have any screening of psychosocial risk recorded and more likely to be thoroughly screened (P < 0.005). Screening was more often documented for less sensitive issues (eg, home, tobacco) than higher risk behaviours (eg, illicit drug use) (P = 0.013). When screening identified risks, appropriate action was undertaken in most cases.


CONCLUSIONS
This study highlights deficiencies in comprehensive health screening in adolescents admitted to a tertiary children's hospital. These results support the development of more consistent approaches to screening adolescent inpatients.
Yeo
Michele S M
MS
Centre for Adolescent Health, Royal Children's Hospital, 2 Gatehouse St, Melbourne, VIC 3052. Michele.Yeo@mcri.edu.au
Bond
Lyndal M
LM
Sawyer
Susan M
SM
D000293:Adolescent; D041923:Adolescent Development; D016497:Adolescent Health Services / Q000706:statistics & numerical data*; D049628:Body Size; D005260:Female; D019538:Health Care Surveys; D006509:Hepatitis B / Q000517:prevention & control; D006760:Hospitalization / Q000706:statistics & numerical data*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data*; D008605:Mental Health Services / Q000706:statistics & numerical data; D012189:Retrospective Studies; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D013503:Surgery Department, Hospital / Q000706:statistics & numerical data; D014611:Vaccination / Q000706:statistics & numerical data; D014739:Victoria