TY - JOUR
T1 - Voluntary progress toward universal newborn hearing screening
AU - Kerschner, Joseph E.
AU - Meurer, John R.
AU - Conway, Ann E.
AU - Fleischfresser, Sharon
AU - Cowell, Melissa H.
AU - Seeliger, Elizabeth
AU - George, Varghese
N1 - Funding Information:
S2000 demonstrated that hospitals with UNHS programs were nearly five times more likely to not need help promoting UNHS as the standard of medical care than hospitals without UNHS programs. Furthermore, with each additional 100 births per hospital, the likelihood of establishing a UNHS program increased by 18%. These are important points for those considering implementation of programs in a large area with widely disparate types of hospitals. Establishment of UNHS as the standard of care can be an important factor for those within an individual hospital or community to help convince hospital administrators, physicians, nurses and others of the importance of such programs. Also, in considering efforts to begin programs, we have documented that smaller institutions often have increased difficulty in establishing programs and a special emphasis is needed to target these institutions and provide additional educational opportunities. The cost of equipment may be prohibitive. The relatively low volume of newborns may reduce opportunities for staff to develop proficiency in screening techniques. Infants with abnormal screens in remote areas may be difficult to reach for diagnostic evaluation and early intervention, if needed. Small, rural hospitals might consider sharing equipment through a program coordinated by regional perinatal centers. The Wisconsin UNHS Implementation Workgroup attempted to overcome the difficulties encountered by these institutions through financial support in the purchasing equipment and targeted educational initiatives. Grants, funded by the Wisconsin Perinatal Foundation, were targeted at hospitals not screening infants and having annual deliveries near or below 300 per year. Seven institutions completed the grant process and received the full amount requested for assistance in purchasing equipment for their UNHS programs. Despite these financial and education efforts, the screening rate in Wisconsin’s smallest birthing hospitals is still significantly lower than in medium-sized to larger hospitals ( Fig. 3 ). This should highlight the special emphasis needed for these areas and the need for ongoing support and education in smaller hospitals even after “successful” programs have been established in most other areas.
Funding Information:
The authors gratefully acknowledge grant support for this research from the Wisconsin Department of Health and Family Services Maternal and Child Health Program and the Children’s Hospital of Wisconsin Foundation. We thank Carri B. Brewer, MPA, for her assistance as a research coordinator, Diane Peters, RN, MS, and members of the Wisconsin Universal Newborn Hearing Screening Workgroup for their valuable contributions to this project. We deeply appreciate the statistical analyses performed by Steven J. Subichin, MS, MBA. We are grateful to Earnestine Willis, MD, MPH, Director of the Center for the Advancement of Urban Children, for her editorial review. We especially thank nurse executives and program managers at Wisconsin hospitals who responded to our surveys.
Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2004/2
Y1 - 2004/2
N2 - Objectives: This study assessed the prevalence of newborn hearing screening in Wisconsin between 1997 and 2001, and examined factors leading to establishment of programs and influencing the outcomes of universal newborn hearing screening (UNHS). The primary goal was to identify characteristics that might be important for states, provinces or countries that have not yet implemented UNHS programs and to examine some unique components of the Wisconsin UNHS program, that may provide direction to areas both with and without programs. Methods: The study consisted of two cross-sectional surveys administered at two separate time points (2000 and 2001). Additional data was provided by the Wisconsin Sound Beginnings Early Detection and Hearing Intervention database. Results: Between 1997 and 2001, the number of Wisconsin birthing hospitals with UNHS programs increased from two to 92 of a total of 103 and the percent of all Wisconsin newborns screened for hearing loss before 1-month of age increased from 10 to 90%. In 2001, 2.6% of screened newborns had an abnormal test requiring further audiologic evaluation, with a higher rate of referral in programs relying only on otoacoustic emission testing versus automatic auditory brainstem testing. As programs were being established, hospitals with greater number of deliveries more readily developed UNHS programs and hospitals with more deliveries were also significantly more likely to screen a greater percentage of delivered children once their programs were established. The Wisconsin Sound Beginnings program established a screening program for home birth infants in 2002 with a current screen rate of 79% for those midwives participating in this program. Conclusions: A vast majority of Wisconsin hospitals have voluntarily implemented UNHS programs. By 2001, greater than 90% of all Wisconsin newborns were screened through a UNHS program. With education, financial support and a statewide network dedicated to UNHS it is possible to establish programs even for infants born in a setting that should be considered high-risk to miss hearing screening, such as home births and hospitals that perform relatively few numbers of deliveries per year. UNHS programs need to develop coordinated systems for linking these programs to audiologic diagnostic services and early intervention programs.
AB - Objectives: This study assessed the prevalence of newborn hearing screening in Wisconsin between 1997 and 2001, and examined factors leading to establishment of programs and influencing the outcomes of universal newborn hearing screening (UNHS). The primary goal was to identify characteristics that might be important for states, provinces or countries that have not yet implemented UNHS programs and to examine some unique components of the Wisconsin UNHS program, that may provide direction to areas both with and without programs. Methods: The study consisted of two cross-sectional surveys administered at two separate time points (2000 and 2001). Additional data was provided by the Wisconsin Sound Beginnings Early Detection and Hearing Intervention database. Results: Between 1997 and 2001, the number of Wisconsin birthing hospitals with UNHS programs increased from two to 92 of a total of 103 and the percent of all Wisconsin newborns screened for hearing loss before 1-month of age increased from 10 to 90%. In 2001, 2.6% of screened newborns had an abnormal test requiring further audiologic evaluation, with a higher rate of referral in programs relying only on otoacoustic emission testing versus automatic auditory brainstem testing. As programs were being established, hospitals with greater number of deliveries more readily developed UNHS programs and hospitals with more deliveries were also significantly more likely to screen a greater percentage of delivered children once their programs were established. The Wisconsin Sound Beginnings program established a screening program for home birth infants in 2002 with a current screen rate of 79% for those midwives participating in this program. Conclusions: A vast majority of Wisconsin hospitals have voluntarily implemented UNHS programs. By 2001, greater than 90% of all Wisconsin newborns were screened through a UNHS program. With education, financial support and a statewide network dedicated to UNHS it is possible to establish programs even for infants born in a setting that should be considered high-risk to miss hearing screening, such as home births and hospitals that perform relatively few numbers of deliveries per year. UNHS programs need to develop coordinated systems for linking these programs to audiologic diagnostic services and early intervention programs.
KW - Auditory brainstem response testing
KW - Home births
KW - Rural hospitals
KW - Universal newborn hearing screening
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U2 - 10.1016/j.ijporl.2003.10.010
DO - 10.1016/j.ijporl.2003.10.010
M3 - Article
C2 - 14725983
AN - SCOPUS:0347951050
SN - 0165-5876
VL - 68
SP - 165
EP - 174
JO - International Journal of Pediatric Otorhinolaryngology
JF - International Journal of Pediatric Otorhinolaryngology
IS - 2
ER -