title: Texas Pulse Oximetry Project: A Multicenter Educational and Quality Improvement Project for Implementation of Critical Congenital Heart Disease Screening Using Pulse Oximetry.
abstract: ObjectiveCritical congenital heart disease (CCHD) is a leading cause of death in infants. Newborn screening (NBS) by pulse oximetry allows early identification of CCHD in asymptomatic newborns. To improve readiness of hospital neonatal birthing facilities for mandatory screening in Texas, an educational and quality improvement (QI) project was piloted to identify an implementation strategy for CCHD NBS in a range of birthing hospitals.Study DesignThirteen Texas hospitals implemented standardized CCHD screening by pulse oximetry. An educational program was devised and a tool kit was created to facilitate education and implementation. Newborn nursery nurses' knowledge was assessed using a pre- and posttest instrument.ResultsThe nurses' knowledge assessment improved from 71 to 92.5% (p< 0.0001). Of 11,322 asymptomatic newborns screened after 24 hours of age, 11 had a positive screen, with 1 confirmed case of CCHD. Pulse oximetry CCHD NBS had sensitivity of 100%, specificity of 99.91%, false-positive rate of 0.088%, positive predictive value of 9.09%, and negative predictive value of 100%.ConclusionOur educational program, including a tool kit, QI processes, and standardized pulse oximetry CCHD NBS, is applicable for a range of hospital birthing facilities and may facilitate wide-scale implementation, thereby improving newborn health.
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 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: Department of Pediatrics, The University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Judith
authors.initials: J
authors.lastname: Livingston
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: Division of Pediatric Cardiology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Elena
authors.initials: E
authors.lastname: Ocampo
authors.affiliation: Section of Neonatology, Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas.
authors.forename: Tiffany
authors.initials: T
authors.lastname: McKee-Garrett
mesh_terms: D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel / Q000193:education*; D006330:Heart Defects, Congenital / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007318:Inservice Training; D008297:Male; D015997:Neonatal Screening; D010092:Oximetry; D058996:Quality Improvement; D012680:Sensitivity and Specificity; D013781:Texas / Q000453:epidemiology