242880 A roadmap to navigating the NICU: Implementing CLSI NBS guidelines in Hawai‘i

Sunday, October 30, 2011

Sarah Scollon, MS, CGC , Genetics Program, Hawaii Department of Health, Honolulu, HI
Venkataraman Balaraman, MD , Division of Neonatology, Kapiolani Medical Center for Women and Children, Honolulu, HI
Kirsty McWalter, MS, CGC , Hawaii Genetics Program, Honululu, HI
Sylvia Mann Au, MS, CGC , Genetics Program, Hawaii Department of Health, Honolulu, HI
Arthur Yu, MS, CGC , Genetics Program, Hawaii Department of Health, Honolulu, HI
In 2009, the Clinical Laboratory and Standards Institute (CLSI) released guidelines regarding newborn screening (NBS) in preterm, low birth, and sick newborns. These guidelines were created in response to the concern that the physiological states of these particular infants often lead to unreliable NBS results. The CLSI guidelines suggest a three part NBS: 1) at the time of admission into a newborn intensive care unit (NICU), 2) 48-72 hours following admission, and 3) day 28 of life or at the time of discharge (whichever comes first). This is in contrast to the “one specimen with repeat specimens as needed” system currently utilized in Hawai‘i.

The Hawai‘i Department of Health Genetics Program (HDOH) and the HDOH NBS program brought together leaders from the NICUs in Hawai‘i to plan how to best implement the CLSI guidelines. It was decided that Hawaii's primary children's hospital would take the lead and launch a pilot program implementing the three part screening guidelines. Educational materials were developed and provided to NICU staff prior to implementation of the project. The educational aims, implementation protocol, and preliminary results of the pilot project will be presented. Discussion will address challenges and successes and proposed statewide implementation strategies. The results of this study will provide requested feedback to the CLSI on practical implementation of the guidelines. Additionally, it can serve as guidance to other NBS programs looking to implement these guidelines within their state.

Learning Areas:
Implementation of health education strategies, interventions and programs

Learning Objectives:
Describe the key points of the CLSI guidelines for newborn screening in NICU infants. Discuss successes and challenges to implementation of the CLSI guidelines.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am involved in facilitating projects related to the improvement of NBS services in the state of Hawaii.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.