Healthy Baby Child Carepath

Purpose

The Healthy Baby Child Carepath (Performing Today) panel is used to record services performed during the current visit. It provides real-time documentation of measurements, immunizations, supplements, conditions, and other scheduled interventions.

Entries are validated by the system and saved once completed, ensuring an accurate clinical record.

Navigation

From the sidebar, expand Patients and select Search.

  • Search for the patient using one or more identifiers.

  • Open the View Patient page.

  • Select Start Visit from the top of the page or the Care Pathways / Plans panel.

  • Choose the visit template: Healthy Baby / Child Carepath or Routine Vaccination option if prompted to create a visit.

Workflow

1

Services Displayed

The panel lists all services scheduled for the encounter, such as:

  • Body weight and height

  • Vaccines (e.g., BCG, HepB, DTP, OPV, PCV, IPV)

  • Supplements (e.g., Vitamin A, iron, zinc)

  • Conditions if applicable (e.g., breastfeeding, disability, allergies)

  • Other interventions depending on the child’s care pathway

2

Action Buttons

  • Complete → Marks the service as performed today and saves it immediately.

    • Once completed, the entry displays the author’s name.

  • Back-Enter → Used when a service was provided before today.

    • Allows staff to enter the Date Performed while the Scheduled Date remains visible for context.

    • Can be undone with Undo Back-Enter.

    • More information: see the Back-Entry Workflow page.

  • Remove → Deletes the service if it was not provided.

3

Growth Measurements

  • Staff enter weight and length/height.

  • The system validates entries and provides feedback:

    • ✅ Normal (green) – within expected range

    • ⚠️ High (red) – abnormally high; prompts nutritional counseling

    • ⚠️ Low (red) – abnormally low; prompts counseling and/or medical review

Alerts do not block the visit but should be reviewed before discharge. They help identify potential growth or nutrition concerns early.

4

Vaccine Administration

When administering a vaccine during a visit, staff must record:

  • Lot # – vaccine lot number used

  • Diluent Lot # – if applicable (e.g., BCG), must match vaccine

  • ADS (Auto-Disable Syringe) Lot # – syringe lot used

  • Administration Site – site of injection (e.g., Left Arm, Left Thigh)

  • Route of Administration – method (e.g., Oral, SC, IM, ID)

Workflow:

  1. Select the vaccine scheduled for today.

  2. Enter all required details (marked with *).

  3. Click Complete – the system saves immediately and marks service as performed.

  4. Confirm the author’s name is displayed.

Other options

  • Not Given → Leave vaccine unchecked or use Remove if the vaccine was not provided.

    • Where supported, select a reason such as Refused, Contraindicated, or Stock-out.

  • VVM Status → Confirm the vaccine vial monitor stage before administering the dose.

  • Unscheduled Doses → If a vaccine is given that was not scheduled for today, use Add → Immunization Administration to record it.

5

Add Menu

The Add button allows staff to add services or conditions not pre-listed for today’s visit.

  • Immunization Administration (unscheduled/catch-up)

  • Adverse Event Following Immunization (AEFI)

  • Supplement Administration (e.g., Vitamin A, iron, zinc)

  • Height Entry

  • Weight Entry

  • Death Report

6

Return to Waiting Room

If services are not complete, or if the patient requires further evaluation, staff can send the patient back to the Waiting Room with a selected status:

  • Awaiting Specialist Care

  • Awaiting Vaccination

  • Held for Observation

Best Practice: Saving and Security Save Early, Save Often

  • The Save button persists the actions completed so far.

  • Use it whenever stepping away from the tablet (e.g., to weigh another child, collect stock, or answer a phone call).

  • If the patient is not being moved to another room/waiting area, use Save to avoid losing data due to timeout or logout.

Leaving the Tablet If you need to leave your tablet unattended:

  1. Press Save on the visit.

  2. Lock the tablet by pressing the power button.

This prevents the risk of leaving patient data visible or editable on an unattended screen.

7

End Visit

Opens a confirmation page that validates services and records the discharge reason.

Actions Performed During Visit

  • Lists all vaccines, measurements, and services scheduled.

  • Staff check off items that were performed; leave uncompleted items unchecked.

Detected Problems

  • Issues (e.g., abnormally low weight) are flagged in yellow boxes.

  • Staff must review and address problems before discharging.

Discharge Reason

This is a mandatory field. Available options may include (examples):

  • Admitted as inpatient

  • Died

  • Discharged to home/self-care

  • Left against medical advice

  • Transferred to another facility/institution

Finalize

  • Cancel → Return to the visit screen without ending the encounter.

  • End Visit → Finalize, remove patient panel, and record discharge details.

Best Practice Before ending the visit, ensure that:

  • All vaccines, supplements, and measurements are recorded.

  • Any Back-Entry data has been saved.

  • AEFI, referrals, or notes are completed where appropriate.

  • All problems or alerts have been addressed.

Clinical Guidelines – Healthy Baby / Child Carepath

This section outlines the recommended vaccines, supplements, and developmental protocols supported in the Healthy Baby / Child Carepath. Each guideline follows the UNICEF South Pacific Immunization Schedule and reflects how the system proposes and validates doses in the Performing Today screen.

Schedule by Age (Quick Reference)

Age / Visit

Vaccine or Supplement

Notes

At Birth

BCG • HepB (Birth Dose) • Vitamin K

Given immediately after birth or before discharge

6 Weeks

PENTA-1 • HEXA-1 • IPV-1 • bOPV-1 • PCV13-1 • RV-1

First primary-series visit

10 Weeks

PENTA-2 • HEXA-2 • IPV-2 • bOPV-2 • PCV13-2 • RV-2

Minimum 4 weeks after Dose 1

14 Weeks

PENTA-3 • HEXA-3 • IPV-3 • bOPV-3 • PCV13-3

Completes primary infant series

6 Months → 5 Years (every 6 months)

Vitamin A

100 000 IU (6–11 mo) • 200 000 IU (12–59 mo)

9 Months

MR-1

Measles-Rubella first dose

15–18 Months

DT Booster 1

First DT booster

18 Months

MR-2

Measles-Rubella second dose

4–6 Years

DT Booster 2

Second DT booster

9 Years +

HPV 1 & 2

Two-dose series 6–12 months apart

Every Visit

Growth Monitoring • Nutrition Review • Developmental Disability Screen

Core components of every child encounter

Immunization and Supplement Schedules

BCG – Tuberculosis Vaccine (At Birth)

Purpose: Protects newborns against severe forms of tuberculosis (TB).

When to Give:

  • At birth or as soon as possible after birth.

  • Proposed automatically if no prior BCG dose is recorded.

Doses & Intervals:

  • Single dose (no boosters required).

System Prompts:

  • Displayed only when Patient Has Not Received BCG Dose.

  • Uses date of birth as actTime.

  • Not proposed beyond the maximum age configured for BCG (typically within 12 months).

Clinical Notes:

  • Verify the child’s immunization card before giving.

  • Record vaccine lot, site (Left Arm), and route (Intradermal).

  • Mark as Completed once administered.

HepB – Hepatitis B Vaccine (Birth Dose)

Purpose: Prevents mother-to-child transmission of Hepatitis B.

When to Give:

  • Within 24 hours of birth.

Doses & Intervals:

  • 1st dose: Birth (HepB0)

  • Further doses are provided as part of PENTA or HEXA schedules.

System Prompts:

  • Proposed only if no prior HepB dose exists.

  • Not shown if already given as part of a combination vaccine.

Clinical Notes:

  • Give before discharge from maternity ward.

  • Inject intramuscularly in the Right Thigh.

  • Record lot number and route.

PENTA – DTP-Hib-HepB Combined Vaccine (6, 10, 14 Weeks)

Purpose: Protects against Diphtheria, Tetanus, Pertussis, Hepatitis B, and Haemophilus influenzae type B.

When to Give:

  • 1st dose: 6 weeks

  • 2nd dose: 10 weeks

  • 3rd dose: 14 weeks

Doses & Intervals:

  • Minimum interval: 4 weeks between doses.

System Prompts:

  • Proposed automatically at each age milestone if earlier doses are completed.

  • Alerts appear if there is an unresolved AEFI or recorded refusal.

  • May be skipped if a HEXA dose (same components + IPV) is recorded.

Clinical Notes:

  • Administer intramuscularly in the Left Thigh.

  • Record the ADS lot number and vaccine vial monitor (VVM) status.

  • Verify no contraindication (e.g., severe allergic reaction to a prior DTP-containing vaccine).

HEXA – DTP-IPV-Hib-HepB Combined Vaccine (6, 10, 14 Weeks)

Purpose: Protects against Diphtheria, Tetanus, Pertussis, Polio, Hepatitis B, and Hib.

When to Give:

  • 1st dose: 6 weeks

  • 2nd dose: 10 weeks

  • 3rd dose: 14 weeks

Doses & Intervals:

  • Minimum 4 weeks between doses.

System Prompts:

  • Proposed if child has not received PENTA or HEXA.

  • Automatically suppressed if equivalent PENTA series already recorded.

  • Generates an alert for any unresolved AEFI.

Clinical Notes:

  • Administer intramuscularly in the Right Thigh.

  • Verify combination supply availability (may replace PENTA + IPV).

DT – Diphtheria and Tetanus (Pediatric Booster)

Purpose: Booster protection following the primary PENTA/HEXA series.

When to Give:

  • 1st booster: 15–18 months

  • 2nd booster: 4–6 years

  • Adolescent booster: at school entry or around age 12.

System Prompts:

  • Appears when the required interval from the last DTP-containing dose has passed.

  • Alerts for unresolved AEFI or refusal.

  • May not display if Td (adult) is scheduled instead.

Clinical Notes:

  • Administer intramuscularly in the Deltoid.

  • Confirm accurate age and previous series completion.

IPV – Inactivated Poliovirus Vaccine (6, 10, 14 Weeks)

Purpose: Protects against poliomyelitis (paralytic polio).

When to Give:

  • 1st dose: 6 weeks

  • 2nd dose: 10 weeks

  • 3rd dose: 14 weeks

Doses & Intervals:

  • Minimum interval: 4 weeks.

  • May be part of HEXA or separate IPV doses.

System Prompts:

  • Proposed only when child has not received IPV as part of HEXA.

  • Alerts for unresolved AEFI.

  • Refusal or contraindication prevents scheduling.

Clinical Notes:

  • Administer intramuscularly in the Left Thigh or Deltoid.

  • Verify prior oral polio (bOPV) doses.

bOPV – Oral Polio Vaccine (6, 10, 14 Weeks)

Purpose: Provides mucosal immunity to prevent poliovirus transmission.

When to Give:

  • 1st dose: 6 weeks

  • 2nd dose: 10 weeks

  • 3rd dose: 14 weeks

Doses & Intervals:

  • Drop formulation (oral).

  • 2 drops per dose.

System Prompts:

  • Proposed automatically with IPV.

  • Alerts for AEFI or refusal.

  • Not proposed if patient deceased or aged beyond upper limit.

Clinical Notes:

  • Administer orally (2 drops).

  • Do not give if child has vomiting immediately—repeat if possible.

PCV13 – Pneumococcal Conjugate Vaccine (6, 10, 14 Weeks)

Purpose: Protects against Streptococcus pneumoniae infections (pneumonia, meningitis).

When to Give:

  • 1st dose: 6 weeks

  • 2nd dose: 10 weeks

  • 3rd dose: 14 weeks

System Prompts:

  • Proposed with primary series vaccines.

  • Will not display if patient already has 3 PCV doses recorded.

  • Alerts for refusal or AEFI.

Clinical Notes:

  • Administer intramuscularly in the Right Thigh.

  • Shake vial well before use.

  • Check cold chain before administration.

MR – Measles-Rubella Vaccine (9 and 18 Months)

Purpose: Prevents Measles and Rubella infections.

When to Give:

  • 1st dose (MR1): 9 months

  • 2nd dose (MR2): 18 months

System Prompts:

  • Appears when patient age ≥9 months.

  • Delayed if AEFI or refusal documented.

  • Must be completed before school entry.

Clinical Notes:

  • Administer subcutaneously in the Left Arm.

  • Check VVM stage before use.

  • Record both lot and diluent numbers.

HPV – Human Papillomavirus Vaccine (Adolescent Girls)

Purpose: Prevents cervical cancer and HPV infection in adolescent girls.

When to Give:

  • 1st dose: at 9 years (or per national guideline)

  • 2nd dose: 6–12 months after the first.

System Prompts:

  • Proposed only for female adolescents.

  • Suppressed if both doses completed.

  • Alerts for unresolved AEFI.

Clinical Notes:

  • Administer intramuscularly in the Deltoid.

  • Provide counseling to caregiver before first dose.

RV – Rotavirus Vaccine (6 and 10 Weeks)

Purpose: Prevents severe rotavirus gastroenteritis.

When to Give:

  • 1st dose: 6 weeks

  • 2nd dose: 10 weeks

Doses & Limits:

  • Must be started before 15 weeks of age.

  • Last dose must be completed before 32 weeks of age.

System Prompts:

  • Proposed only if within allowable age window.

  • Alerts if child exceeds maximum age.

  • Warns if AEFI exists for rotavirus vaccine.

Clinical Notes:

  • Administer orally (2 mL).

  • Do not re-dose if vomiting occurs after administration.

Vitamin A – Supplementation (6 Months to 5 Years)

Purpose: Prevents vitamin A deficiency and supports immune function and vision.

When to Give:

  • Starting at 6 months, then every 6 months until age 5.

Doses & Intervals:

  • 100,000 IU for infants 6–11 months.

  • 200,000 IU for children 12–59 months.

System Prompts:

  • Proposed every 6 months if within eligible age range.

  • Suppressed if already given for that interval.

Clinical Notes:

  • Administer orally.

  • Record supplement batch number.

  • Offer at immunization or growth monitoring visits.

Vitamin K – Supplementation (At Birth)

Purpose: Prevents bleeding disorders in newborns due to Vitamin K deficiency.

When to Give:

  • Immediately after birth (preferably within 24 hours).

Doses & Intervals:

  • Single dose (1 mg IM).

System Prompts:

  • Proposed automatically for newborns without a recorded dose.

  • Uses date of birth as actTime.

Clinical Notes:

  • Administer intramuscularly in the Thigh.

  • Check for any birth complications before administration.

Development & Nutrition Protocols

Childhood Nutrition – Infant Feeding Status

Purpose: Monitors infant feeding practices to support healthy growth and identify risks of malnutrition.

When to Collect:

  • At registration and every 3 months until the child is weaned.

System Prompts:

  • Proposed automatically if last feeding status was recorded more than 3 months ago.

  • Suppressed if infant is marked as weaned.

Clinical Notes:

  • Record current feeding type (exclusive breastfeeding, mixed, formula-fed).

  • Reinforce breastfeeding counseling and safe weaning practices.

Childhood Healthy Growth – Weight and Height Monitoring

Purpose: Ensures that every child’s growth is routinely measured and evaluated to detect early signs of undernutrition, stunting, or obesity.

When to Collect:

  • At each Healthy Baby / Child Carepath visit.

  • Proposed automatically if no recent growth record exists.

  • Should be updated even if the child appears healthy.

System Prompts:

  • Based on the Childhood Healthy Growth protocol.

  • Prompts for both Height and Weight entries.

  • Generates color-coded alerts after saving:

    • ✅ Normal (Green) – within expected range

    • ⚠️ High (Red) – above range; prompts nutritional counseling

    • ⚠️ Low (Red) – below range; prompts clinical review

Clinical Notes:

  • Measure height to the nearest 0.1 cm and weight to the nearest 0.1 kg.

  • Ensure the child is undressed or in light clothing.

  • Review growth trends and counsel caregivers as needed.

  • Record all entries directly within the Performing Today panel.

Developmental Disability – Cognitive and Learning Screening

Purpose: Screens for developmental delay, learning difficulties, and cognitive impairment to ensure early identification and intervention.

When to Collect:

  • Starting from 2 months of age, at registration, and during routine follow-up visits.

  • Proposed automatically for children and adolescents where no previous record exists.

System Prompts:

  • Suggested by the system under the Childhood Cognitive Function Protocols.

  • Suppressed if a recent Developmental Disability assessment has already been recorded.

Clinical Notes:

  • Observe and record milestones such as communication, social interaction, and motor development.

  • Ask caregivers about learning, speech, or behavioral concerns.

  • Document findings under Child Special Needs Observation.

  • Refer for further assessment if delay or disability is suspected.

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