Health Authority – Abu Dhabi أبوظبي- ھــیئـــــة الصحة

Title: HAAD Standards for School Health ScreeningVer.: 1.0Reference: PHR/FSH/01

Issue Date: November 2010Next Review Date: November 2011

1. Purpose1.1 This standard is intended to ensure that students of Grade 1-12 receive the requisite health

screening interventions during the schooling period. To do this, it mandates the :1.1.1 the school screening schedule;1.1.2 the service specifications for school health screening; and1.1.3 the data recording and reporting requirements for the school screening

programme.1.2 The clinical care pathways provided at Appendices 1-8 in this Standard provide additional

advisory guidance to healthcare professionals to support quality, evidence-based screeningservices to students.

2. Scope2.1 This standard applies to all Healthcare Facilities (including school clinics) and Professionals

licensed by HAAD in the Emirate of Abu Dhabi who provide school screening services withintheir scope of practices.

2.2 This standard applies to screening of students in public and private schools

3. Duties for Health ProfessionalsAll licensed healthcare facilities and professionals engaging in screening of school students must:3.1 report and submit data to HAAD via the school health reporting system and in accordance

with the HAAD Reporting of Health Statistics3.2 refer students with positive screening results as per internationally accepted best practice;

HAAD Public Health Protocols (Appendices 2 - 8) are advisory in this regard.

Clinical services and patient care and data reporting must be delivered in accordance with thelaws and regulations of the Emirate of Abu Dhabi and consistent with HAAD policies andstandards.

4. Enforcement and Sanctions4.1 HAAD may impose sanctions in relation to any breach of duties under this standard

consistent with the HAAD Reporting of Health Statistics Policy and in accordance with the[HAAD Policy on Enforcement and Sanctions].

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5. Data recording and reporting5.1 HAAD requires all licensed healthcare professionals to submit data on healthcare delivery

and health statistics. Reporting of data under this standard must comply with the HAADReporting of Health Statistics Policy.

5.2 School Health screening data should be recorded in the student file. The templatesincluded in this standard are advisory in this regard.

5.3 The relevant fields must be reported on the HAAD data reporting e-notifications systemwithin 1 month of the screening being conducted.

6. Standards6.1 All HAAD licensed healthcare providers in Abu Dhabi are authorized to provide screening

for school students provided they meet this Standard.6.2 The screening tests described in this standard can be performed by a trained HAAD

licensed school nurse, physician or allied health professional specializing in the screeningfield.

6.3 Screening staff (school nurses, physicians and dentists) should refer all students withpositive screening results by sending a referral letter to parents and encouraging them toget follow up within a month provided the case is not urgent.

7. Communication7.1 All communication regarding the school screening must be in accordance with HAAD

Policies and Standards, including general confidentiality and consent policies available atwww.haad.ae.

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Appendix 1: School Screening Tests Schedule

Grade 1 2 3 4 5 6 7 8 9 10 11 12Medical historyM √ * * * √ * * * √ * * *BMIM √ √ √ √ √ √ √ √ √ √ √ √Vision M √ √ √ √ √ √ √ √ √ √ √ √HearingR √ * * * √ * * * √ * * *Physical ExaminationR √ √ √Complete blood countR √ √ (f)Dental screeningR √ √ √

Additional information: In addition, school nurses should give health promotion guidance to students during individual consultation and to groups,

on topics including nutrition, physical activity, preventing injuries, smoking prevention oral health and mental health. School nurses should request a medical history for all students joining the school (including KG). If a child joins the screening programme for the first time, all catch-up screening tests must be done.

Key:m: Malef: FemaleM: MandatoryR: Highly recommended*: Screen when clinicallyindicated

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Appendix 2 General Guidelines:

Parents and students should be educated on the screening tests and School Nurses and visitingscreening teams should, as far as possible, answer parents‘ queries on the tests andaccommodate requests to view the screening facilities.

An external screening test may be accepted if it has been done not more than twelve monthsprior to the commencement of the school year in which the screening is required, and fulfils allthe criteria outlined in Appendices 1-8. Parents should provide the screening results signed by aphysician to the school before the scheduled screening.

It is recommended that whenever possible, all previous screening results be made available tothe visiting physician.

Appendix 3: Consent

Parent consent must be obtained for all screening testso BMI, vision and hearing tests: A letter will be sent to parents explaining that those tests

will be performed unless the parents refuse through a letter or a phone call to theschool;

o Consent for physical examination, CBC and dental screening: to be performed on thebasis of parent‘s or gurdian‘s signed consent form.

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Appendix 7: Oral Health Assessment (ver 1.0)1

The following dental services must be carried out by a HAAD licensed dentist or professionaloperating within the scope of his or her practice.Grade 1 5 9Clinical Oral Examination2 √ √ √Assess oral growth and development3 √ √ √Caries – risk assessment4 √ √ √Prophylaxis and topical fluoride6 √ √ √Fluoride supplementation7 √ √ √Anticipatory guidance/ counseling8 √ √ √Oral hygiene counseling9 Patient/

ParentPatient/Parent

Patient/Parent

Dietary counseling10 √ √ √Injury prevention counseling11 √ √ √Counseling for nonnutritive habits12 √ √ √Anti-tobacco counseling √Assessment and treatment of developingmalocclusion

√ √ √

Assessment for pit and fissure sealants in permanentteeth13

√ √ √

Refer where clinically indicated for radiographicassessment5

√ √ √

1Adapted from the American Academy of Pediatric Dentistry. Clinical Guidelines of examination, preventativedental services, anticipatory guidance, and oral treatment for infants, children and adolescents.2First examination at the eruption of the first tooth and no later than 12 months. Repeat every 6 months or asindicated by child's risk status/susceptibility to disease.3By clinical examination.4Must be repeated regularly and frequently to maximize effectiveness.5Timing, selection, and frequency determined by child's history, clinical findings, and susceptibility to oraldisease.6Consider when systemic fluoride exposure is suboptimal.7Up to at least 16 years.8Appropriate discussion and counseling should be an integral part of each visit for care.9Initially, responsibility of parent; as child develops, jointly with parent; then, when indicated, only child.10At every appointment; initially discuss appropriate dietary practices, then the role of refined carbohydratesand frequency of snacking in caries development and childhood obesity.11Sports and routine playing.12For school-aged children and adolescent patients, counsel regarding any existing habits such as fingernailbiting, clenching, or bruxism.13For caries-susceptible primary molars, permanent molars, premolars, and anterior teeth with deep pits andfissures; placed as soon as possible after eruption.

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Appendix 8: Physical examination & Complete Blood Count (CBC)

Physical Examination

A licensed physician should perform the comprehensive medical examination to studentsaccording to the HAAD schedule and include all the items outlined in Form 1 which should bekept in the student’s folder.

A signed consent form must be present. Any physical examination done in another Healthcare Facility may be accepted if it has been

done not more than twelve months prior to the commencement of the school year in whichthe examination is required, and covers all an assessment of all the required elements. Parentsshould submit the physical examination, signed by a physician to the school before thescheduled physical examination;

The School Nurse should provide the physician doing the physical examination with, wheneverpossible the results of previous screening including history, BMI, vision and any available bloodtest results.

Complete Blood Count (CBC) A HAAD licensed phlebotomist or other HAAD licensed professionals acting according to their

scope of practice, should draw blood, label the tubes and request forms and organise the CBCanalysis according to standard best practice guidelines.

Results should be documented in Form 2 which is kept in the student‘s folder. A CBC done at a HAAD licensed Health Facility may be accepted if it has been done not more

than twelve months prior to the commencement of the school year in which the CBC isrequired. Parents should submit the CBC results to the school before the scheduled screening.

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Template 1: Student Screening History & Physical (ver 1.0)Student name Date of Birth:

Grade:N = Normal, Ab = Abnormal, NA = Not Applicable. Please specify abnormal findings.Physical Examination FindingsHistory

General Appearance

Vital Signs:

Body temperature,

Pulse rate (or heart rate),

Blood pressure,

Respiratory rate

Skin, Hair

HEENT (Head, Eye, Ear, Nose, Throat)*

Heart (Murmur, Rhythm)

Lungs

Abdomen/ Hernia

Genitalia (undescended testicles,Hydrocele)

Sexual Development

Musculoskeletal System(including vertebral column alignment)

Impression/Diagnosis

Referral (Y/N)

Referred (to)

Response received(date)

Doctor

* Check for Strabismus, Conjunctivitis, Hearing, Otitis, Pharyngitis, Neck Mass, Lymph nodes

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Template 2 : Details of Complete Blood CountStudent name Date of Birth:

Grade/Class

Date oftest

Complete Blood Count

Hb HCT

WBC

RBC

MCV

MCH

MCH

C

RDW

Oth

er

Remarks

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