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Comparison of universal newborn hearing screening programs in Illinois hospitals
Lia M Ferro1, Gail Tanner, Susan F Erler
1Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL 60208, USA.
Insights
Illinois hospitals screen nearly all newborns for hearing loss using otoacoustic emissions and auditory brainstem response. While practices align with national standards, audiologist involvement and rural program management need improvement.
Area of Science:
- Pediatrics
- Audiology
- Public Health
Background:
- Illinois mandated Universal Newborn Hearing Screenings (UNHS) by December 2002, requiring all birthing hospitals to participate.
- Current practices in Illinois involve otoacoustic emissions (OAEs) and automated auditory brainstem response (AABR) for infant hearing assessments.
- This study aims to document and compare current UNHS practices in Illinois hospitals with established standards.
Purpose of the Study:
- To document current hospital-based Universal Newborn Hearing Screening (UNHS) programs in Illinois.
- To compare reported UNHS practices with recommended standards.
- To identify areas for improvement in UNHS program implementation and management.
Main Methods:
- A modified Newborn Hearing Screening Survey was administered online to hospital staff in Illinois.
- Data were collected for the 2004 calendar year, focusing on screening practices and protocols.
- The survey gathered information on personnel involvement, screening tools, and referral rates.
Main Results:
- Fifty-nine of 140 Illinois hospitals responded to the survey.
- Nursing staff and technicians primarily performed initial screenings; audiologists were more involved in re-screenings.
- Automated ABR (80%) was the most common screening tool; referral rates were generally low (86% <5%, 32% <1%).
Conclusions:
- In early 2004, 99% of Illinois infants were screened for hearing loss, with practices comparable to other states.
- Audiologists had limited roles in screening, re-screening, and program management.
- Improvements are needed in managing UNHS programs in rural facilities, tracking high-risk infants, and family support services.
Unlabelled:
SUMMARY/OBJECTIVES: In accordance with the Joint Committee on Infant Hearing's (JCIH, 2000) position statement regarding Universal Newborn Hearing Screenings (UNHS), the state of Illinois enacted legislation requiring all birthing hospitals to conduct UNHS by 31 December 2002. Currently 100% of birthing facilities in the state of Illinois perform newborn infant hearing screenings using otoacoustic emissions (OAEs) and/or automated auditory brainstem response (AABR) measures. This study is an attempt to document current practices in hospital-based UNHS programs, as reported by program personnel, in the state of Illinois. The goal is to compare these reported practices to the recommended standards and identify factors that could lead to further refinement of the process.
Methods:
A modified version of the Newborn Hearing Screening Survey from the Marion Downs National Center for Infant Hearing was used to gather practice- and protocol-related data for the 2004 calendar year via the World Wide Web. Data presented here are extracted from the online survey as reported by hospital staff presumably associated with the UNHS program.
Results:
Fifty-nine of the 140 hospitals with UNHS programs responded to the Web-based survey. Nursing staff, followed by technicians, were most commonly reported to perform initial hearing screenings in both the well-baby nursery (WBN) and the neonatal intensive care unit (NICU). Audiologists appeared to participate in re-screenings at a greater number of the facilities. Automated ABR was the most common screening tool (80%) followed by Distortion Product OAEs (32%) and Transient Evoked OAEs (5%). Eighty-six percent reported referral rates that were less than 5%, with 32% reporting a referral rate less than 1%.
Conclusions:
At the beginning of 2004, 99% of all infants born in Illinois were being screened for hearing loss. Personnel involvement and screening measures employed were comparable to the few reports available from other states. The audiologist's role was found to be fairly limited in screening, re-screening, or managing UNHS programs. Referral rates were consistent with national standards ( approximately 1%). Management of UNHS programs in small, rural facilities, tracking/monitoring high-risk infants, and other services provided to families emerged as areas with room for improvement.
