Implementation of Critical Congenital Heart Disease Screening in Minnesota

被引:33
作者
Kochilas, Lazaros K. [1 ]
Lohr, Jamie L. [1 ]
Bruhn, Eric [4 ]
Borman-Shoap, Emily [2 ]
Gams, Becky L. [3 ]
Pylipow, Mary [3 ]
Saarinen, Annamarie [5 ]
Gaviglio, Amy [6 ]
Thompson, Theodore R. [3 ]
机构
[1] Univ Minnesota, Dept Pediat, Div Pediat Cardiol, Minneapolis, MN 55454 USA
[2] Univ Minnesota, Dept Pediat, Div Gen Pediat, Minneapolis, MN 55454 USA
[3] Univ Minnesota, Dept Pediat, Div Neonatol, Minneapolis, MN 55454 USA
[4] Pediat Cardiac Care Consortium, Minneapolis, MN USA
[5] Newborn Coalit, Washington, DC USA
[6] Minnesota Dept Hlth, St Paul, MN USA
关键词
congenital heart disease; newborn screening; pulse oximetry; PULSE-OXIMETRY; NEWBORN-INFANTS; TEST ACCURACY; DEFECTS;
D O I
10.1542/peds.2013-0803
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
OBJECTIVE: To assess the level of preparedness and resources needed in Minnesota for the implementation of newborn screening for critical congenital heart diseases (CCHDs). METHODS: A cross sectional survey of all birth centers in Minnesota was performed to assess the capacity to deliver care essential for the CCHD screening program. Compliance with the screening algorithm, nursing workload, and cost were assessed by using a pilot program implemented in 6 normal newborn nurseries. RESULTS: Ninety-one of 99 eligible centers participated in the survey and 90 reported the ability to screen newborns in accordance with recommendations. Only 22 centers, with 63% of births, had access to echocardiography and routinely stocked prostaglandins for neonatal use. Our pilot study screened 7549 newborns with 6 failed screens and 1 CCHD diagnosis. Two of the failed screens were due to misinterpretation of the algorithm, 1 failed screen was not reported, and 4 failed screens were not recognized. Repeated screens were required for 115 newborns, with 29% of retesting due to misinterpretation of the algorithm. The mean nursing time required was 5.5 minutes, and the cost was $5.10 per screen. CONCLUSIONS: In Minnesota, two-thirds of newborns are born in centers with resources for initial diagnosis and management of CCHD. Implementation of a pilot screening program demonstrated minimal increase in nursing workload, but identified problems with interpretation of the algorithm and data reporting. This pilot project suggests the need for simplification of the algorithm, additional training of health care providers, and development of a centralized reporting mechanism.
引用
收藏
页码:E587 / E594
页数:8
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