Christy M Cockfield, Gloria D Garner, Jack C Borders
{"title":"Follow-up after a failed newborn hearing screen: a quality improvement study.","authors":"Christy M Cockfield, Gloria D Garner, Jack C Borders","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":79417,"journal":{"name":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"ORL-head and neck nursing : official journal of the Society of Otorhinolaryngology and Head-Neck Nurses","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
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.