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The Newborn Hearing Screening Programs At Inova Hospitals

Learn about the comprehensive newborn hearing screening programs at Inova Fairfax Hospital for Women & Children and Inova Fair Oaks Hospital. These programs employ advanced technology and follow specific protocols for universal screening and rescreening.

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The Newborn Hearing Screening Programs At Inova Hospitals

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  1. The Newborn Hearing Screening Programs At Inova Hospitals Ken Henry, Ph.D. Inova Fairfax Hospital For Women & Children Falls Church, VA Inova Fair Oaks Hospital Fairfax, VA

  2. Inova Fairfax NHS Program • Fairfax Hospital Census Approaches 11,000 Newborns Per Year • Average of 30 Per Day /Census Often Exceeds 50 Per Day • Level I NICU (50 Bed) • Fair Oaks Hospital Census Exceeds 3,000 Per Year • The Two Hospitals Represent Nearly 1/6 Of The Annual Birthing Census In The State Of Virginia

  3. Inova Fairfax NHS Program • Personnel Considerations • Two Or More Screeners Present Every Day • One Screener Per Floor • Twelve Part-time Screeners (3 Audiologists) • Universal Screening Performed Daily • Three To Five Hours Per Day • Separate Protocols For WBN and NICU

  4. 2 Automated OAE Systems (EchoCheck) One Unit Per Floor One Additional Backup System 2 Clinical OAE Systems (EchoPort ILO 88 TEOAE) One Unit Per Floor Quickscreen Protocol Equipment - Fairfax Hospital

  5. Inova Fair Oaks NHS Program • Personnel Considerations • Ave. 11 Newborns Per Day • One Screener Daily • Equipment • 1 Automated OAE System (EchoCheck) 1 Clinical OAE System (EchoPort ILO 88) • Quickscreen Protocol

  6. Inova Fairfax Hospital Protocol • Well Newborn Screening Initially Began With 2 Stage Process • OAE (EchoPort) • AABR (Algo 2e) • AOAE (EchoCheck) • Evolved To A One Stage Screening • Rescreen Clinic – Two Stage Screen • Repeat TEOAE • AABR If Necessary

  7. AOAE versus OAE • The Efficacy of UNHS Was Well Established Using TEOAEs • We Were “Skeptical” About The Capability Of Automated OAE Technology • 247 Newborns Were Assessed With AOAE, OAE and AABR. None Passed The AOAE And Subsequently Failed The OAE or AABR

  8. AOAE versus OAE • 33 Did Not Pass the AOAE (EchoCheck) But Did Subsequently Pass The OAE and AABR Conducted Immediately After Initial Screen • 12 Did Not Pass the AOAE Or OAE But Did Pass The AABR • Implications?

  9. The Use Of AABRSome “Unfair” Statistics • 804 AABR records • AABR Screenings Were Conducted On Newborns Who Referred On First Stage Screen With TEOAE • Average test time - 11.7 minutes

  10. Inova Fairfax Hospital For ChildrenMulti-Stage Assessment

  11. Inova Fairfax HospitalMulti-Stage Screen - TEOAE and AABR

  12. Inova Fairfax HospitalTEOAE ONLY

  13. Inova Fairfax Hospital Protocol • Separate Protocol For Screening Well Newborns and NICU Newborns • Active Level I Nursery • Clinical TEOAE and ABR Depending On Medical Status

  14. Birthweight = OR <1000 Grams Birthweight 1001-1250 Grams (look at vent use & stability of baby- if “rocky” course- ABR if very stable- OAE TORCH APGAR score at 5min. equal to or less than 6 Severe asphyxia, hypoxic ischemia, encephalopathy protracted seizures Craniofacial anomalies Chromosomal Abnormalities CNS Abnormalities IVH (Grade 2 or above) PVL hydrocephalus malformations meningitis PPHN Hyperbilirubinemia requiring exchange transfusions NICU Protocol For Diagnostic ABR

  15. Neonatal Screening Program For Inova Hospitals(Well Baby Nursery)

  16. When Do You Refer For Diagnostic Audiology and/or Medical Evaluation? JCIH 2000 recommendations for EDHI states: “ All infants who do not pass the birth admission screen and any subsequent rescreening begin appropriate audiological and medical evaluations to confirm the presence of hearing loss before 3 months of age”

  17. OUTPATIENT RESCREEN CLINIC

  18. SUMMARY OF EHDI PROCESS

  19. “Summary” • Newborn Census and Personnel Will Dictate Choice in Equipment/Technology • Time-Cost Analysis Of Protocol • Final Outcome • Impact On The Community • Follow-Up • Personnel Resources • Parental Considerations • Insurance Considerations

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