A nurse-driven algorithm to screen for congenital heart defects in asymptomatic newborns

Routine pulse oximetry screening (POS) performed on asymptomatic newborns after 24 hours of life, but before hospital discharge, may detect critical congenital heart defects (cCHD) when used as an adjunct to physical examination. Timely identification of this small percentage of newborns prompts early intervention and improves outcomes. New-generation, highly accurate pulse oximeters provide a simple, low-risk, low-cost tool to improve detection of potentially lethal cardiac lesions. The purpose of this study was to develop, implement, and test the utility of a nurse-driven algorithm that would support and serve as a guide for detection of cCHD in asymptomatic newborns using POS prior to discharge home from the hospital. Results showed that this collaborative protocol was easily implemented in a community hospital. The universal algorithm enhances POS and clinical examination to identify asymptomatic infants with undiagnosed cCHD prior to discharge from the hospital.