Lindsey's vision gives student midwives the best start

A nurse examining a baby's eyes

It’s the question every new parent asks when their baby arrives: Is everything OK?

An innovative app conceived at ARU is helping midwives to feel confident about carrying out a vital check on the health of the new arrival. They know that the earlier a problem is recognised, the sooner something can be done to help.

Babies are screened for congenital abnormalities within 72 hours of birth and again between six and eight weeks of age under the Newborn Infant and Physical Examination (NIPE) programme. Of the four basic checks in NIPE – hips, heart, eyes and testes in boys – it was the eye check that bothered Lindsey Rose, Senior Lecturer in Midwifery at ARU.

She got together with Roger Chittock, the university’s commercialisation officer, to work with app developers Cambridge Digital Health to create Eye Screen. Eye Screen is an app that allows students training to be midwives the opportunity to gain the experience they need in performing the eye check correctly.

Midwives must be able to recognise the signs of serious eye conditions, but some of them are rare, with Public Health England estimating that two or three in every 10,000 babies require treatment. As a result, a midwife may only rarely encounter a condition in practice.

Eye Screen offers users a library of photographs so that students can learn to recognise the different conditions. The idea for improving what was available came from Lindsey’s own experience, having completed a research project looking at students’ ability to recognise a particular condition. “It proved to me that we needed a tool to teach this better,” she says.

Getting together with Roger was the first step. They took the idea to a Dragons’ Den-style pitching contest that gave them the opportunity to work with Cambridge Digital Health to create the app. Which is where Roger’s skills came to the fore. The pitch was successful and Cambridge Digital Health went on to create the app.

Lindsey worked with a consultant colleague to gather the vital raw material, genuine pictures of the rare conditions that they wanted student midwives to become familiar with.

It’s important not only to ensure that rare conditions are recognised, but also to avoid uncertain students referring too many perfectly healthy babies for specialist diagnosis, causing worry for families and needlessly overloading busy clinics. And Eye Screen, which is available for Android and iOS devices, is really making a difference. “The students start using the app from year one,” says Lindsey. “They get three years of experience of looking at eye conditions right from the start.”

Eye Screen presents users with 20 images and asks them to say whether the eye is healthy or not. The results, with explanations, can be downloaded as a PDF for the student’s records. The pictures are randomised so that the selection will always be different – and they are continuing to add new images to the library all the time. Lindsey says: “The beauty of the technology is that as soon as something changes, you update it.”

Lindsey remembers one student who was concerned about a baby and pushed for a referral because she was sure that there was a problem. She was able to use her knowledge from the NIPE course and all the practice she had done using Eye Screen to give a rationale for her referral. The baby did indeed have a real problem and giving a student that confidence in their own judgment when they have recognised a problem underlines the value of Eye Screen.

It’s not just helping ARU students training to be the midwives of tomorrow. Word has got around at Addenbrooke’s Hospital in Cambridge and many of the qualified midwives there have Eye Screen downloaded so that they can use it to check their skills are as good as ever. Some other universities have also come on board and started using Eye Screen themselves.

Lindsey and Roger are keen for more and more midwifery students to have the chance to use Eye Screen. But that’s not the limit of their ambitions.

Remember those four checks that make up the early NHS screening for babies? Having come up with an app for eye checks, Lindsey and Roger have plans to repeat their success with improved training for spotting problems across all four elements of the NIPE programme. Watch this space.

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