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Critical congenital heart disease screening requires simplification
The screening algorithm for critical congenital heart disease in newborns should be simplified, according to recent study findings published in Pediatrics.
“The instability of resources critical for the management of [critical congenital heart disease] supports the need for a centralized system to assess hospital readiness to recognize and treat newborns with [critical congenital heart disease],” Lazaros K. Kochilas, MD, of the University of Minnesota, and colleagues wrote.
The cross-sectional survey included 91 birth centers in Minnesota. A pilot program implemented in six normal newborn nurseries was used to evaluate compliance with the screening algorithm, nursing workload and cost.
Researchers found that 90 of the birth centers had the ability to screen newborns in accordance with recommendations; however, only 22 centers had access to echocardiography and normally stocked prostaglandins for neonatal use. There were six failed screens and one critical congenital heart disease diagnosis of 7,549 screened newborns. Misinterpretation of the algorithm was the cause of two failed screen, one was not reported and four were not recognized. Repeat screens were needed in 115 newborns because of 29% misinterpretation of the algorithm. Mean nursing time required was 5.5 minutes and cost was $5.10 per patient.
“Our data suggest that need for simplification of the screening algorithm, additional training of health care providers and development of standards for data collection, electronic results reporting, and a centralized reporting and review mechanism,” researchers wrote. “This experience will be used for refinement of the screening program and resource allocation in Minnesota as screening is implemented statewide. We hope that this experience will provide a framework for implementation in other states facing similar challenges.”
Disclosure: The researchers report no relevant financial disclosures.
Lazaros Kochilas, MD, can be reached at University of Minnesota Amplatz Children’s Hospital, 2450 Riverside Ave., Minneapolis, MN 55454; email: kochilas@umn.edu.
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