Subject: CCHD Newborn Screening

POLICY: All newborns born in The Birth Center will be screened for Critical Congenital Heart Disease according to the algorithm published by The Centers for Disease Control.

GUIDELINES: 1. All newborns will be screened with the portable pulse oximeter just prior to discharge.

2. All newborns with Oxygen Saturations equal to or greater than 95% in the right hand or right foot will be considered a negative screen and noted in the newborn’s birth chart.

3. All newborns will be rescreened at the two day visit following screening protocols.

4. All newborns with Oxygen Saturations equal to or greater than 95% in the right hand or right foot will be considered a negative screen and noted in the newborn’s chart.

5. All newborns that have a positive screen will be referred to the Pediatrician for follow up.

·         The Pediatrician will be called to determine what follow up is necessary for this particular infant.

·         The appointment with the Pediatrician will be set by the birth assistant prior to discharge from The Birth Center and will be noted in the newborn’s chart

·         OR – the client will be called within 2 days to determine if the appointment has been made and the information will be noted in the newborn’s chart.

PROCEDURE: 1. Each newborn will have their oxygen saturation measured prior to discharge from The Birth Center; ideally within one hour of discharge from the center.

2. The newborn will have the pulse oximeter placed on their right foot and right hand and the reading will be taken.

·         A reading of equal to or greater than 95% and less than or equal to 3% difference between the right hand and foot will be considered a negative screen and noted in the newborn’s birth chart.

·         A reading of 90% to 95% or greater than 3% difference between right hand and foot will need a rescreen.

·         Rescreens may be done every hour x two. 

·         If the reading still is not negative on the third screen then the screening is positive and needs pediatric follow up.

3. Each newborn will have their oxygen saturation measured at their two day newborn exam at The Birth Center.

4. The two day old newborn will have the pulse oximeter placed on their right foot and right hand and the reading will be taken.

·         A reading of equal to or greater than 95% and less than or equal to 3% difference between the right hand and foot will be considered a negative screen and noted in the newborn’s chart.

·         A reading of 90% to 95% or greater than 3% difference between right hand and foot will need a rescreen.

·         Rescreens may be done every hour x two. 

·         If the reading still is positive on the third screen then the screening is positive and needs pediatric follow up.

5.  All clients will be given the follow up CCHD information sheet and will be counseled and supported through their questions and fears.

6. Pediatric follow up may consist of calling the client’s own Pediatrician or Primary Children’s Hospital for the on call Pediatrician.

7. The client will be called post the follow up appointment to assure proper care for the infant and maternal supportive needs.