Rapid Implementation of Pulse Oximetry Newborn Screening to Detect Critical Congenital Heart Defects — New Jersey, 2011

• Published in: MMWR. Morbidity and mortality weekly report 2013-04, Vol.62 (15), p.292-294
• Main Authors: Garg, Lorraine F, Knapp, Mary M, Beres, Leslie M, Van Naarden Braun, Kim, Hinton, Cynthia F, Cassell, Cynthia H, Olney, Richard S, Peterson, Cora, Glidewell, Jill
• Format: Article
• Language: English
• Subjects: Congenital heart defects; Congenital heart disease; Data collection; Genetic disorders; Heart Defects, Congenital - diagnosis; Hospitals; Humans; Infant, Newborn; Infants (Newborn); Morbidity; Mortality; Neonatal disorders; Neonatal screening; Neonatal Screening - methods; Neonatal Screening - organization & administration; New Jersey; Newborns; Outcome Assessment, Health Care; Oximetry; Patient monitoring equipment; Pulse oximetry; Questionnaires; Screening questions; Time Factors
• ISSN: 0149-2195; 1545-861X

In August 2011, New Jersey implemented a statewide newborn screening protocol for critical congenital heart defects (CCHD) using pulse oximetry. In January 2012, CDC responded to a request from the New Jersey Department of Health (NJDOH) to assist with an assessment of the implementation. Out of the 52 birthing facilities in New Jersey, a sample of 11 was selected. Staff interviews were conducted to assess screening and data collection processes, data flow and tracking procedures, electronic medical record (EMR) capabilities, and capacity to report data to NJDOH. Feedback also was obtained about the questionnaire being used to follow-up on positive screening results. All 11 facilities were screening for CCHD. Among the 11 facilities, three were electronically entering and maintaining data into an EMR, five were manually entering and maintaining data into paper charts and logs, and three were both electronically and manually entering and maintaining data. Facilities reported that implementation of newly mandated CCHD screening posed a low burden to hospital staff members. NJDOH receives aggregate pulse oximetry screening data from all New Jersey birthing facilities. During the first 3 months of screening, preliminary data indicated that 98.2% of 25,214 newborns were screened. Hospitals reported data on 12 newborns with positive screening results; two newborns were newly diagnosed with CCHD as a result of pulse oximetry screening. Because of state-specific factors, such as out-of-state referral patterns, these findings might underestimate the anticipated number of positive screens in states with varying referral patterns and use of prenatal diagnosis. Rapid implementation of universal CCHD screening posed a relatively low burden to hospitals in New Jersey.