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 healthy newborns. CHD symptoms may develop days or weeks after discharge and a newborn may quickly decompensate, which results in devastating sequelae. A simple pulse oximetry reading performed 24 hours after birth may identify newborns in need of further cardiac evaluation.
To 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. Because of the seriousness of undiagnosed CHD and the 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 neonatal intensive care unit.
Implementation, Outcomes, and Evaluation
Nursing management was charged with creating a program to educate families, screen newborns, and create an algorithm that would ensure 100% compliance. Additionally, the program would include physician notification, further evaluation, and follow-up when indicated.
Within 7 weeks from idea conception, the program was created, all staff educated, and competency was ensured. The results of this successful program were reported to the state legislature as part of the testimony supporting the Connecticut General Assembly Bill #56.
Implications for Nursing Practice
Nursing can be effective in developing and implementing evidence-based practice in a rapid time frame to improve quality of care. This process can be duplicated in other hospitals and with other projects.