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Louisiana Department of Health & Hospitals | Kathy Kliebert, Secretary

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Statewide Initiatives



211 - Get Connected. Get Answers.

SAMPLE POLICY AND PROCEDURES FOR NEWBORN SCREENING

Purpose: To Screen all babies born at ___________________ Hospital prior to discharge from the hospital.

1. Scrub In:
• Begin by washing hands according to hospital protocol
• Remove rings and watch (jewelry is not to be worn when handling babies)
• Put on clean gloves and gown

2. Obtain hearing screening requests:
• Determine via nursery census babies needing screening
• Test any new babies or babies needing re-screening due to refer on screening test number 1
• From baby's chart, retrieve the state pink hearing screening form

3. Prioritize infants to be tested:
• Begin with babies that are in danger of being discharged without testing
• Next, test any babies that did not pass the day before. We always want to retest a baby if possible (test at least 2 times, but not more than 4 times)
• Test any baby that can be tested...don't assume they will be there the next day
• If nurses are doing their assessments, ask permission before taking the baby
• If pediatricians are making rounds ALWAYS immediately give the baby to the pediatrician, even if you are in the middle of testing
• If the baby is under a bilirubin light, ask the nurse if it is ok to take the baby out from under the light for testing
• If you have a baby that is in need of testing, but is moving too much: try wrapping tightly, put a blanket over the bassinet to block out some light, give the baby a pacifier if he has one, or put a clean glove on and allow the baby to suck on your pinkie finger
• If a baby has been readmitted, the baby must be retested even if they passed their original newborn hearing screening
• Babies who do not receive testing because of being transferred; still need the pink sheet completed. Mark on the pink sheet the "transferred to" box and please fill out hospital of transfer. Be sure to indicate where baby is being transferred to.

• Babies who are transferred into this hospital will be treated as babies born at this hospital in regards to hearing screening

4. Begin testing:
• Pull all paperwork on baby you are testing
• Begin testing (refer to OAE and ABR instructions for detailed information on running test and troubleshooting guide)
• Do not attempt to get a "pass" more than 4 times

5. Retrieving baby from the room:
• There will be times when the baby is not in the nursery and you will need to retrieve baby from the mom. Explain to mom that you are going to take the baby for hearing screening. Reassure her that it is an easy test that takes 15-30 minutes and the baby will probably remain sleeping throughout the entire test

6. Parents who refuse testing:
• Parents must sign and date "refusal to test" from. This form should be photocopied. The original should go in the Audiology folder kept in the nursery, and the copied form should be placed in the baby's chart

7. Paperwork if baby passes:
• Fill out Audiology log sheet, complete with all identifying information and results
• Fill out pink state hearing screening form and date, check all appropriate information
• Place state hearing screening form in the baby's chart
• Complete Hearing Screening Progress Note in medical chart
• Log baby's results in the nursery birthing log
• Complete billing sheet

8. Paperwork if baby refers:
• Fill out Audiology log sheet, complete with all identifying information and results
• DO NOT complete pink state hearing screening form - form will be completed at 2nd screening attempt
• Place state hearing screening form in baby's chart for the next screener to complete
• Complete Hearing Screening Progress Note in medical chart
• Log baby's results in the nursery birthing log
• Complete billing sheet
• If baby referred, it is mandated that the baby have a follow-up appointment scheduled upon discharge. Call 222-3333 and schedule the baby for an outpatient appointment for 2-4 weeks after discharge
• Fill out section on pink form with follow-up information
• Give the parents "Your Baby Needs Another Test" brochure with all of our clinic information detailed on it

9. Equipment Issues:
• If you have any questions or problems while testing, I am always available to you by phone at 225-444-5555. You may refer to the troubleshooting guide for help as well. The equipment manufacturer is also available at 800-666-7777