Implementing Universal Pulse Oximetry Screening in West Virginia: Findings from Year One

In March 2012 the West Virginia legislature passed a law that mandates birth hospitals to perform pulse oximetry screening for all well-babies in the newborn nursery to improve the detection of critical congenital heart disease (CCHD). CCHD screening data collection began on September 1, 2012 at all 28 birthing hospitals. 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.

All WV birth hospitals were provided with the U.S. Department of Health and Human Services recommendations for CCHD screening, and the Center for Disease Control's recommended screening algorithm for review and reference. 20,115 infants were entered into the Birth Score database between September 1, 2012 and August 31, 2013. 19,283 (91%) infants were screened for CCHD.

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 of the 19 infants who failed the screening had a transthoracic echo report available for review. Of those 17 infants reviewed, seven were diagnosed with CCHD.

85% of the infants born in WV who received a Birth Score during the year reviewed were screened for CCHD. Given that the goal is to have 100% compliance with the pulse oximetry screening, additional investigations into factors affecting compliance may be necessary.