title: Effect of universal neonatal transcutaneous bilirubin screening on blood draws for bilirubin analysis and phototherapy usage.
abstract: OBJECTIVE
  To determine the effect of universal transcutaneous bilirubin (TcB) screening on total serum bilirubin (TSB) blood draws and phototherapy usage.
  
  
  METHODS
  The subjects were infants ≥ 36 weeks gestation. In period 1, TSB was ordered based on clinical factors. In period 2, all infants underwent predischarge TcB measurement; infants with adjusted TcB values in the high-intermediate or high-risk zones had TSB ordered. Data were extracted through chart review.
  
  
  RESULTS
  TSB measurements per 1000 infants decreased from 717 to 713 (P=0.008) between period 1 and 2, with more outpatient and less inpatient blood draws in period 2. Between periods 1 and 2, total phototherapy decreased from 59 to 39 per 1000 infants (P<0.0001), with less inpatient and more readmission phototherapy.
  
  
  CONCLUSIONS
  Universal TcB screening was implemented without increasing total blood draws or phototherapy treatment; however, it was associated with a shift in blood draws and phototherapy usage from inpatients to outpatients.
authors.affiliation: Department of Pediatric & Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: A C
authors.initials: AC
authors.lastname: Wickremasinghe
authors.forename: B S
authors.initials: BS
authors.lastname: Karon
authors.forename: A K
authors.initials: AK
authors.lastname: Saenger
authors.forename: W J
authors.initials: WJ
authors.lastname: Cook
mesh_terms: D001663:Bilirubin / Q000032:analysis*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000453:epidemiology* / Q000628:therapy*; D007231:Infant, Newborn; D007755:Laboratories, Hospital; D015997:Neonatal Screening / Q000639:trends; D018962:Phlebotomy / Q000706:statistics & numerical data*; D010789:Phototherapy / Q000706:statistics & numerical data; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies
chemical_list: D001663:Bilirubin