title: Comparison of Newborn Hearing Screening in Well-Baby Nursery and NICU: A Study Applied to Reduce Referral Rate in NICU.
abstract: OBJECTIVE
  To determine whether newborn hearing screening in a well-baby nursery (WBN) and neonatal intensive care unit (NICU) nursery: 1) meet three targeted, screening, referral, and diagnostic follow-up rates; 2) compare the average age of diagnosis for infants admitted to the WIN and NICU; and 3) determine prevalence of hearing loss in neonatal population; and 4) try to find a practical newborn hearing screening time algorithm to reduce refer rate in NICU.
  
  
  METHODS
  It examined 15,624 newborns in the WBN (13,676) and NICU (1948) screened for congenital HL using AABR. The variables analyzed in it were the screening rate, referral rate, follow-up rate, diagnostic rate and diagnostic age, prevalence rate, degrees of congenital bilateral HL. The study was approved by the hospital's institutional review board (13MMHISO23).
  
  
  RESULTS
  The screening rates were 99.8% and 99.6% in the WBN and NICU groups, respectively, without significant difference. The referral rates were 0.7% and 2.8% in the WBN and NICU groups, with significant difference. Furthermore, the diagnostic follow-up rates were 76.7% and 89.1% in the WBN and NICU groups, without significant difference. The average initial diagnostic ages were 1.9 months and 3.8 months in the WBN and NICU groups, with significant difference. The prevalence of congenital bilateral hearing loss were 0.27% and 1.6% in the WBN and NICU groups, with significant difference.
  
  
  CONCLUSIONS
  The screening, referral and follow-up rate in the WBN and NICU groups were equivalent to the quality indicators. For NICU group, screening and diagnostic follow up were performed later than those in WBN group; however the lower referral rate in our NICU group was successfully achieved in this study and can be applied clinically. The prevalence of congenital bilateral hearing loss was higher in the NICU group than in the WBN group.
authors.affiliation: Department of Audiology and Speech Language Pathology, Mackay Medical College, Taipei, Taiwan.
authors.forename: Pei-Chun
authors.initials: PC
authors.lastname: Li
authors.affiliation: Department of Speech and Hearing Disorders and Sciences, National Taipei College of Nursing, Taipei, Taiwan.
authors.forename: Wei-I
authors.initials: WI
authors.lastname: Chen
authors.affiliation: Department of Otolaryngology, Mackay Memorial Hospital, Taitung, Taiwan.
authors.forename: Chih-Ming
authors.initials: CM
authors.lastname: Huang
authors.affiliation: Department of Audiology and Speech Language Pathology, Mackay Medical College, Taipei, Taiwan.
authors.forename: Ching-Ju
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Department of Audiology and Speech Language Pathology, Mackay Medical College, Taipei, Taiwan.
authors.forename: Hsiu-wen
authors.initials: HW
authors.lastname: Chang
authors.affiliation: Department of Audiology and Speech Language Pathology, Mackay Medical College, Taipei, Taiwan.|Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan.|Department of Medicine, Mackay Medical College, Taipei, Taiwan.
authors.forename: Hung-Ching
authors.initials: HC
authors.lastname: Lin
mesh_terms: D006309:Hearing / Q000502:physiology*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D015997:Neonatal Screening; D009724:Nurseries, Infant; D010045:Outpatients; D010351:Patient Discharge; D012017:Referral and Consultation