Importance of Head Circumference and Length Measurement in Infant Evaluation

The article discusses the importance of head circumference and length measurement in infant evaluation. It also talks about routine immunization and flu vaccine for infants. The content emphasizes the need for measuring head circumference and length, checking eyes, muscle tone, reflexes, and other concerns like feeding, pooping, peeing, and sleeping. It also highlights the importance of flu vaccine and routine immunization for infants. The article suggests ways to improve the quality of care in immunization delivery and the role of supply chain leadership and management of human resources in functional immunization supply chain.

Running head: PSYCHOLOGY
Psychology
Name of the Student
Name of the University
Author note

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Answer one
From the case study, it can be witnessed that certain parameters were not measured by the
nurse, Jane, like head circumference and length. Head circumference measurement or distance
around the largest part of the head gives important information about the brain development
(Villar et al. 2014). The head circumference smaller or bigger than the normal milestone indicate
problem. A large head indicate hydrocephaly where there is building of fluid inside the brain. An
abnormal or stopped growth is indicated if the head is small. Length measurement was also not
taken into consideration as head circumference for age and weight for length need to be put on
the growth chart (Streiner, Norman and Cairney 2015). Eyes need to checked for any sort of
congenial eye infections, blocked ducts or discharge along with body muscle tone and baby’s
reflexes. As Ellie is 7 months old, concerns like feeding, pooping, peeing and sleeping should
also be taken into consideration. As this age, solid food could be introduced like single-grain
cereal that is iron-fortified. There is also need to notice the change in the colour and consistency
of stool after the introduction of solids.
Sleeping is also important as in the age of 6 months, an infant need 12 to 16 hours sleep
with naps up to two to three time in the daytime. The grasping ability and passing of objects need
to be checked for Ellie along with rolling and posture like sitting with support for the evaluation
of motor skills. At this stage, immunizations are most important and as Ellie is already 6 months
old, she is due for her first flu shot in the flu season. The nurse did not give flu vaccine to Ellie
and Centres for Disease Control and Prevention (CDC) recommends that flu vaccine be
recommended for infants above the age of 6 months. As Flu vaccines constantly change, the
vaccine need to be updated with the current strains of flu virus (Dawood et al. 2012). The routine
immunization can be improved through maximization of quality services, management of

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immunization programs, people mobilization and monitoring of programme performance by the
authority with 2 doses of seasonal flu vaccine (tri or quadrivalent) from 6 months onwards
regardless of immunization history.
Answer two
As Ellie is 7 months old and never received flu vaccine, it is recommended that two doses
of vaccine be recommended that would protect her from flu season in 2017 as outlined by CDC.
As Ellie missed her first flu vaccine inadvertently with no second dose within the same year, she
should receive two doses in the following year in 4 weeks apart recommended for infants below
the age of 9 months as recommended by CDC.
Dosage Week 1 Week 2 Week 3 Week 4 Outcome
Flu vaccine 0.25 ml 1st dose Protection
against
influenza
virus
0.25 ml 2nd dose
After first dose administration, fever may or may not occur that is considered a
precaution for flu vaccine. The nurse should look for any side effects after first flu shot like low-
grade fever, swelling and pain at the injection site, muscle aches, fatigue or headache. It lasts for
one or two days and is less severe. The routine immunization of flu vaccine can be strengthened
by a well-functioned cold chain supply and system, improvement in equity with efficient service
delivery and capacity building of supervisors and vaccinators (Kartoglu and Milstien 2014).
Management and political support, effective planning, strategy and policy development can also

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improve the quality of care in immunization delivery. There should be active engagement of
caretaker and community for demand generation and mobilizing people. Finally, monitoring of
program performance can be done through rigorous influence disease surveillance, immunization
schedule, analysis and evaluation.
Answer three
Supply chain leadership and management of human resources is important and serves as
backbone for functional immunization supply chain. This approach helps in developing a
workforce that is comprised of competent and dedicated supply chain leaders having adequate
amount of accountable, motivated, empowered and skilled personnel at every healthcare system
levels (Yadav et al. 2014). Cold chain equipment can be used for the successful immunization
program where vaccines need to be transported and stored within recommended temperature and
verified through proper monitoring (Zaffran et al. 2013). Influenza vaccines are important to be
stored in certain given condition that can be helpful in addressing the problem of missing dose of
flu vaccine for 6 month olds.
Organizations and communities need to take active part in routine immunization
including managers and health planners to change radically the phase of vaccine service-delivery
schedules. According to organizational theory, community health workers and nurses need to
identify the structures and patterns in the inefficient immunization service delivery so that there
is no missing of vaccine schedule, maximizing efficiency and meet the expectations of service
users (Shafritz, Ott and Jang 2015).
Force field analysis can be used for analysing situations in organizational change
processes. Supply chain management in immunization is dynamic, complex, context specific and

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multifaceted from service provider as well as user perspective. In this analysis, driving forces
like changing organizations, new personnel, community capacity building, legislation, politics
and shareholders serves as positive forces in improving the quality of care in immunization
delivery (Mitchell 2013). On a contrary, restraining forces like organizational inertia block the
objective of quality care improvement and therefore, strengthening of driving forces and
weakening of restraining forces through change management can be helpful in effective
immunization delivery.
Answer four
The Policy for the Seasonal influenza vaccination 2018 in healthcare settings is
developed with an aim to minimize the transmission of flu virus and distribute million of doses
of vaccine in Australia (Heinrich-Morrison et al. 2015). NSW Health is working in collaboration
with Department of Health for the management of influenza vaccine supplies under the National
Immunization Program. Community participation is important immunization programs to
provide services in convenient place and time, proper access to immunization services and good
quality of care with no missing of vaccine doses. The management need to train nurses and other
healthcare team staffs providing ever information to them that is related to immunizations while
working with service users across while communicating effectively with them and maintaining
vaccine safety. The communities also need to involve communities in the program monitoring
and surveillance. Identification of community volunteers, defining responsibilities, training,
supportive supervision, mentoring and feedback along with needed incentives are required to
outreach immunization session working in collaboration with government in tracking children
and their immunization status and motivating caregivers in routine immunizations (Partapuri,
Steinglass and Sequeira 2012).

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References
Dawood, F.S., Iuliano, A.D., Reed, C., Meltzer, M.I., Shay, D.K., Cheng, P.Y., Bandaranayake,
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Heinrich-Morrison, K., McLellan, S., McGinnes, U., Carroll, B., Watson, K., Bass, P., Worth,
L.J. and Cheng, A.C., 2015. An effective strategy for influenza vaccination of healthcare workers
in Australia: experience at a large health service without a mandatory policy. BMC infectious
diseases, 15(1), p.42.
Kartoglu, U. and Milstien, J., 2014. Tools and approaches to ensure quality of vaccines
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Mitchell, G., 2013. Selecting the best theory to implement planned change. Nursing
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Shafritz, J.M., Ott, J.S. and Jang, Y.S., 2015. Classics of organization theory. Cengage Learning.
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