title: A Multicenter Initiative for Critical Congenital Heart Disease Newborn Screening in Texas Neonatal Intensive Care Units.
abstract: ObjectiveThe objective of this study was to implement a strategy for critical congenital heart disease (CCHD) newborn screening in the neonatal intensive care unit (NICU).DesignA NICU-specific curriculum, screening algorithm, slide presentations, and templates of orders, policies, and procedures were developed into a toolkit for training NICU personnel. Screening was conducted on first and second screen pre- and postductal oxygen saturations (SpO2) on newborns admitted or transferred to the NICU.ResultsWe trained 347 NICU personnel in 13 Texas hospitals, representing rural, suburban, and metropolitan settings. Key hospital staff submitted deidentified, case-based screening data. Of 4,621 NICU admissions, 80% received a first screen. Second screening rates were substantially lower in all gestational age groups. Screening rates on first and second screens were lowest among infants born < 28 weeks. For the first screen, SpO2was lowest among the youngest gestational ages. The false positive rate was 2.3%.ConclusionCCHD screening in the NICU is challenging, given the complexities of the NICU population. A modified screening protocol that recognizes special circumstances of neonatal intensive care could facilitate a more efficient system.
authors.affiliation: Department of Pediatrics, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Alice
authors.initials: A
authors.lastname: Gong
authors.affiliation: Section of Neonatology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Charleta
authors.initials: C
authors.lastname: Guillory
authors.affiliation: Department of Health Management and Systems Sciences, University of Louisville School of Public Health and Information Sciences, Louisville, Kentucky.
authors.forename: Liza
authors.initials: L
authors.lastname: Creel
authors.affiliation: Department of Pediatrics, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Judith Ellen
authors.initials: JE
authors.lastname: Livingtson
authors.affiliation: Section of Neonatology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: McKee-Garrett
authors.affiliation: Section of Neonatology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Regine
authors.initials: R
authors.lastname: Fortunov
mesh_terms: D016638:Critical Illness; D005189:False Positive Reactions; D005260:Female; D005865:Gestational Age; D006282:Health Personnel / Q000193:education; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D015997:Neonatal Screening; D010092:Oximetry; D013781:Texas / Q000453:epidemiology