An Improved Hearing Screening Protocol for the Most Vulnerable Infants

POSTER

An Improved Hearing Screening Protocol for the Most Vulnerable Infants McKenzie Blatt, BSN, DNP Student Adrienne Johnson, AuD, and Jennifer L. Hamilton, APRN DNP CPNP-PC Key Findings: Implementation of a Hearing Screening Readiness Tool, paired with provider education, resulted in improved timing of initial hearing screening in neonates born at an EGA ≤ 34 weeks. Results Background The prevalence of childhood hearing loss is higher in those admitted to the Newborn Intensive Care Unit (NICU) Research has shown that early detection and intervention greatly improves long-term neurodevelopmental outcomes for hearing impaired neonates (Wroblewska-Seniuk et al., 2017) Evidence shows that the automated auditory brainstem response (AABR) hearing screen can be reliably performed at approximately 34 weeks corrected gestation (van Straaten, Tibosch, Dorrepaal, Dekker, & Kok, 2001) Methods Single Level III NICU in the Salt Lake region Baseline provider knowledge regarding newborn hearing screening was assessed with the use of a survey Current literature and expert opinion were utilized to tailor a protocol specific to unit needs based on the results gathered from the survey and chart review A paper screening tool was developed which alerts providers to hearing screen readiness The electronic health record was utilized to track hearing screening data pre and post intervention A pre intervention survey was distributed to 21 practitioners prior to implementation of the hearing screening assessment tool with 71% completion (n = 15) The paper screening tool was utilized 55% (n=55) of the time in the post intervention population Post implementation, neonates born at an estimated gestational age (EGA) > 34 weeks, on average received initial hearing screening on DOL 10, statistical significance was not achieved in this population (p = 0.37) Neonates born at an EGA ≤ 34 weeks, on average received initial hearing screening post intervention 12 days after reaching 34 weeks CGA. A significance level of 0.001 (p < 0.01) Conclusion The majority of practitioners surveyed agreed the process for alerting audiology could be improved upon and clarification was needed regarding current newborn hearing screening recommendations This project had the biggest impact on neonates born at an EGA ≤ 34 weeks, timing of initial hearing screening was greatly improved in this population Screening tool utilization was limited, this can be attributed to the nature of a paper screening tool and reliance on provider participation. Development of an electronic screening tool would likely increase utilization and decrease dependence on provider participation COLLEGE OF NURSING