Fast Track Initiation of a Congenital Heart Disease Screening Program

Purpose for the program:

Congenital Heart Disease (CHD) is a common newborn heart defect that is often asymptomatic. These newborns are discharged home as seemingly well newborns. CHD symptoms may develop days or weeks after discharge and newborn may quickly decompensate, resulting in devastating sequelae. A simple pulse oximetry reading performed 24 hours after birth may identify newborns in need of further cardiac evaluation.

Proposed change:

Develop and implement a pulse oximetry screening program for all newborns in a suburban hospital. Traditionally a process such as this takes 6 months to a year to fully integrate into practice. Due to the seriousness of undiagnosed CHD and potential Connecticut state mandate for CHD screening, the hospital’s department of pediatrics felt an urgent need to put this process into place. The proposed practice change would include all newborns in well nursery and the NICU.

Implementation, outcomes and evaluation:

Nursing management was charged with creating a program to educate families, screen newborns and create an algorithm which would ensure 100 percent compliance. Additionally the program would include physician notification, further evaluation and follow up when indicated.

Within the seven weeks from idea conception the program was created, all staff were educated and competency was assured.  The results of this successful program were reported to the state legislature as part of testimony supporting CT General Assembly Bill #56.

Implications for nursing practice:

Nursing can be effective in developing and implementing evidence based practice in a rapid time frame in order to improve quality of care. This process can be duplicated in other hospitals and with other projects.

Keywords: congenital heart disease, pulse oximetry screening, competency, education