Document Detail


Follow-up after a failed newborn hearing screen: a quality improvement study.
MedLine Citation:
PMID:  23311112     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
OBJECTIVE: Universal newborn hearing screening (UNHS) has been implemented for several decades to screen for congenital hearing loss; however, the lost to follow-up (LFU) rate for newborns with a failed screen is nearly 50%. Many studies have examined risk factors rendering infants susceptible to being LFU, but there are no quality improvement studies using evidence-based practice that aim to improve follow-up rates. This study utilized a nurse practitioner (NP) to provide a teaching intervention to educate parents on recommended follow-up after a failed hearing screen, including the Healthy People 2020 objectives.
METHODS: Seventeen newborn/mother couplets were recruited to participate in a multi-site quality improvement project over a six week period prior to hospital discharge. At the bedside with the NP, mothers completed a demographic survey and were provided education on Georgia's UNHS Program and recommended follow-up based on the Healthy People 2020 objectives. An appointment with the hospital's audiologist was given to the mother in writing. A retrospective chart review was performed three months after the newborn's birth to document follow-up with audiology or to see if the infant was lost to follow-up for audiologic evaluation (LFUAE).
RESULTS: Of the 17 newborns enrolled, 14 had adequate follow-up with audiology within three months of birth. Hospital A showed statistical significance with one newborn that was LFUAE when compared to the nation LFU rate (n=12, p=0.01). Prior to project intervention, Hospital B had a 70% LFUAE rate; however, its post intervention LFUAE rate decreased to 40% (n=5). Statistical significance was unable to be obtained due to small sample size. Two mothers reported smoking during pregnancy and both of their newborns were LFUAE.
CONCLUSIONS: This project suggests that education by the NP prior to hospital discharge was statistically significant at Hospital A. Health care providers should actively engage in educating parents regarding expected follow-up guidelines and incorporating the Healthy People 2020 objectives. Further studies are needed that can also examine the six month follow-up with pediatric otolaryngology for hearing aid fitting and early intervention.
Authors:
Christy M Cockfield; Gloria D Garner; Jack C Borders
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses     Volume:  30     ISSN:  1064-3842     ISO Abbreviation:  ORL Head Neck Nurs     Publication Date:  2012  
Date Detail:
Created Date:  2013-01-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206573     Medline TA:  ORL Head Neck Nurs     Country:  United States    
Other Details:
Languages:  eng     Pagination:  9-13     Citation Subset:  N    
Affiliation:
Medical University of South Carolina College of Nursing, Charleston, SC, USA.
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