Their Hearts in Our Hands: Implementation of Screening for Critical Congenital Heart Disease in a Level I Nursery

Newborn Care Poster Presentation Purpose for the Program The purpose of this presentation is to describe how we have been able to implement pulse oximetry screening for critical congenital heart diseases (CCHDs) in our level I nursery through the use of an evidence‐based tool kit, which was developed by the Children's National Medical Center (CNMC). Universal CCHD screening has been endorsed by the American Academy of Pediatrics, the United States Department of Health and Human Services (HHS), the National Association of Neonatal Nurses (NANN), other prominent healthcare organizations, and grassroots efforts by families of children who have been affected by CCHD. Many infants who suffer from CCHD are asymptomatic and may experience developmental delays, sudden onset of symptoms, or even unexpected death. Pulse oximetry is a noninvasive screening tool, which has great potential to reduce both morbidity and mortality in the newborn population. Many states have passed legislation that requires that CCHD screening be offered by hospital nurseries, but it is not yet mandated in Pennsylvania. Though we are a small community hospital, it is our hope to be a leader in the promotion of good health in our community. Proposed Change All neonates born at Hanover Hospital will be screened for CCHD unless the procedure is declined by the family or the neonate is transferred to another facility. Staff are trained to perform screening according to guidelines described in the tool kit. Women giving birth at our facility and their families are informed of the CCHD screening in childbirth education classes, written educational materials, and through bedside teaching with our nursing and pediatric medical staff. Data gathered will be shared with CNMC pending approval of the director of Hospital Information Management. Implementation, Outcomes, and Evaluation The staff was trained to use the equipment and educated on evidence that supports screening. Screening was implemented in March 2012. To date, of the 292 neonates that have been screened, one had a positive CHDD test result and was referred for outpatient follow‐up. Implications for Nursing Practice Neonates cared for at our facility are screened for CCHD using the most current guidelines. In response to initial misinterpretations, the electronic medical record has been modified to actively prompt the end user to rescreen, report, or conclude screening based on the data entered. It is hoped that through the collaboration to share our data with CNMC, our relationship may evolve and facilitate additional sharing of knowledge.