Smooth implementation of critical congenital heart defect screening in a newborn nursery

Abstract

In January of 2012, University of Arkansas for Medical Sciences began implementation of a critical congenital heart disease screening program to identify newborns with structural heart defects. The screening used motion tolerant pulse oximeters in direct sequence to measure the oxygen levels in the right hand and either foot of eligible newborns. Exclusion criteria included echocardiogram prior to discharge, age greater than 7 days with continuous neonatal intensive care unit monitoring, or death or transfer prior to discharge. Of the 1905 infants screened, 3 infants failed screening. Two of the infants had atrial septal defects, and 1 had a patent foramen ovale, which was considered a false positive. After planning and education, the implementation of critical congenital heart disease pulse oximetry screening was successful. With only 1 false positive in our high-risk population, this should encourage other institutions to begin screening eligible infants.

Keywords: congenital heart defect; newborn screening; quality improvement.