title: Timing of Newborn Pulse Oximetry Screenings for Critical Congenital Heart Defects Before Discharge.
abstract: OBJECTIVE
  To determine if there would be positive results from a second pulse oximetry screening (POS) completed for newborns at discharge at 28 to 48 hours of age in addition to the newborn POS completed at 24 to 25 hours of age.
  
  
  METHODS
  Prospective descriptive research study.
  
  
  METHODS
  Rural, mid-Atlantic, 13-bed, level I hospital.
  
  
  METHODS
  Newborns (N = 1,002) at 35 weeks' gestation or older discharged from the newborn nursery.
  
  
  METHODS
  Registered nurses (RNs) performed POS at 24 to 25 hours of age (POS 1) and at discharge but less than 48 hours of age (POS 2). Data related to critical congenital heart defects were collected.
  
  
  RESULTS
  There were no positive POS results (O2 saturation ≤ 90%) at POS 1 or POS 2, and no additional diagnostic tests were ordered as a result of POS. Although one full-term newborn had negative results at POS 1 and POS 2, the RN identified a murmur, and a subsequent echocardiogram was used to detect tetralogy of Fallot and pulmonary atresia. The RNs detected concerning conditions in 14 newborns that resulted in 28 additional tests, including echocardiograms (9), chest x-ray imaging (8), laboratory testing (7), electrocardiograms (3), and ultrasound imaging (1).
  
  
  CONCLUSIONS
  The POS-positive result rate was 0 for newborns at POS 1 and POS 2. Therefore, our study findings supported Maryland's mandate of one POS completed within 24 to 48 hours of birth. Nurses must continue to be vigilant about assessing newborns, including screening for critical congenital heart defects and congenital heart defects.
authors.forename: Lynn
authors.initials: L
authors.lastname: Crouch
authors.forename: Karen Gabel
authors.initials: KG
authors.lastname: Speroni
authors.forename: Ruth Ann
authors.initials: RA
authors.lastname: Jones
authors.forename: Eileen P
authors.initials: EP
authors.lastname: MacDougall
authors.forename: Marlon G
authors.initials: MG
authors.lastname: Daniel
mesh_terms: D042241:Early Diagnosis; D005260:Female; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods / Q000458:organization & administration; D015403:Nursing Evaluation Research; D010092:Oximetry / Q000379:methods*; D010351:Patient Discharge; D011446:Prospective Studies; D013997:Time Factors
keywords: CCHD; CCHD screening and pulse oximetry; infant; newborn screening