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Follow-up after a failed newborn hearing screen: a quality improvement study
Christy M Cockfield1, Gloria D Garner, Jack C Borders
1Medical University of South Carolina College of Nursing, Charleston, SC, USA.
Summary
A nurse practitioner teaching intervention significantly improved newborn hearing screening follow-up rates. Educating parents on audiology appointments reduced infants lost to follow-up, addressing a critical public health gap.
Area of Science:
- Pediatrics
- Public Health
- Quality Improvement
Background:
- Universal newborn hearing screening (UNHS) aims to detect congenital hearing loss early.
- Nearly 50% of infants with failed screens are lost to follow-up (LFU), hindering timely intervention.
- Existing research identifies LFU risk factors but lacks quality improvement studies to enhance follow-up rates.
Purpose of the Study:
- To implement and evaluate a nurse practitioner-led educational intervention to improve follow-up rates after failed newborn hearing screens.
- To educate parents on recommended audiology follow-up, aligning with Healthy People 2020 objectives.
Main Methods:
- A quality improvement project involving 17 newborn/mother dyads over six weeks.
- Nurse practitioners provided bedside education on UNHS and follow-up protocols.
- Retrospective chart review at three months post-birth assessed audiology follow-up or LFU for audiologic evaluation (LFUAE).
Main Results:
- 14 out of 17 infants (82%) had adequate audiology follow-up within three months.
- Hospital A achieved statistical significance, reducing LFUAE compared to national rates (p=0.01).
- Hospital B's LFUAE rate decreased from 70% to 40% post-intervention; maternal smoking was linked to LFUAE in two cases.
Conclusions:
- Nurse practitioner-led education prior to hospital discharge significantly improved audiology follow-up rates.
- Healthcare providers should prioritize parent education on follow-up guidelines and Healthy People 2020 objectives.
- Further research is recommended to assess six-month follow-up for hearing aid fitting and early intervention services.
