142nd APHA Annual Meeting and Exposition

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301786
Implementing Universal Pulse Oximetry Screening in Newborns through the West Virginia Birth Score Program

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Sunday, November 16, 2014

Collin John, MD, MPH , Department of Pediatrics, West Virginia University, Morgantown, WV
John Phillips, MD , Department of Pediatrics, West Virginia University, MORGANTOWN, WV
Candice Hamilton, MPH , Department of Pediatrics, West Virginia University, Morgantown, WV
Allison Lastinger, MD , Department of Pediatrics, West Virginia University, MORGANTOWN, WV
Background: In March 2012 the West Virginia legislature passed a law that mandates all hospitals to perform pulse oximetry screening for all newborns to improve the detection of critical congenital heart disease (CCHD). The screening item was added to the West Virginia Birth Score form, an existing tool also mandated by state law for all infants born in WV.  It was implemented at all 28 birthing hospitals on September 1, 2012. The purpose of this study was to review the first year of pulse oximetry screening outcomes and identify barriers to implementation and solutions to improve tracking and policy.

Methods: All WV birth hospitals were provided with the U.S. Department of Health and Human Services recommendations, and the Center for Disease Control’s recommended screening algorithm for review and reference. 21,115 infants received a Birth Score between September 1, 2012 and August 31, 2013. 19,283 (91.3%) infants were eligible for the pulse ox screening.

Results: 17,101 (88.5%) infants passed, 19 infants failed, and 2,163 (11.2%) infants had missing data for the screening. 832 infants were not screened due to being admitted to the neonatal intensive care unit for reasons unknown. 17 infants had transthoracic echo reports available for review, of which seven were diagnosed with CCHD.

Conclusions: 88.8% of the infants who received a Birth Score during the year reviewed were confirmed as being screened. Given that the goal is to have 100% compliance with the pulse oximetry screening, additional investigations into factors affecting compliance may be necessary.

Learning Areas:

Epidemiology
Program planning
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
Describe how pulse oximetry screening was implemented for all newborns in West Virginia. Discuss the challenges of 100% compliance with pulse oximetry screening and data collection in West Virginia birth hospitals. Demonstrate understanding of the challenges associated with new state mandates and policy implementations at the hospital level.

Keyword(s): Screening Instruments, Public Health Policy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a clinical professor of Pediatrics and have been the Principal Investigator and Medical Director for the WV Birth Score Program state funded grant since 2012.
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.

Back to: 2035.0: Poster Session: Infant & Child Health